Role of Ultrasonic Assessment of Cervical Length and Amniotic Fluid Index in Predicting Delivery Latency Period Following Preterm Premature Rupture of Membranes

INTRODUCTION: Premature rupture of the membranes (PROM) is defined as spontaneous membrane rupture that occurs before the onset of labour. When spontaneous membrane rupture occurs before 37 weeks of gestation, it is called as preterm premature rupture of membranes (PPROM). The term latency refers to the time from membrane rupture to delivery. Infants delivered after preterm premature rupture of membranes are at high risk for gestational age dependent and infection related morbidity and mortality. Thus knowing about factors affecting latency would allow timely intervention to reduce all these complications. AIMS AND OBJECTIVES: To assess the role of amniotic fluid index (AFI) and cervical length in prediction of delivery latency period among women with preterm premature rupture of membranes. METHODOLOGY: This was a prospective observational study performed during November 2015 to March 2017 in the Department of Obstetrics and Gynecology, Smt Sucheta Kriplani Hospital, Lady Hardinge Medical College, New Delhi on 106 singleton pregnant women between 28 weeks to 34 weeks gestation with cephalic presentation and preterm premature rupture of membranes. All the women were subjected to ultrasound for determining AFI and cervical length and were followed up until delivery. RESULTS: Out of 106 women, 95 women underwent into spontaneous labour were included in study. Forty-six women delivered within 7 days of test and 49 delivered afterwards. Out of 46 women, 34 (73.91 %) had amniotic fluid index of ≤5cm and 31 (67.39) % women had cervical length of ≤ 2 cm. The sensitivity, specificity, positive and negative predictive value of AFI alone in predicting delivery within 7 days were 73.91 %, 65.31 %, 66.67 % and 72.73 % respectively. The sensitivity, specificity, positive and negative predictive value of cervical length alone in predicting delivery within 7 days were 67.39 %, 73.47 %, 70.45 % and 70.59 % respectively. Out of 95 women, 33 had both the characteristics, (am