Myometrial Thickness as a Predictor for the Latency Interval in PPROM
Myometrial Thickness as a Predictor for the Latency Interval in PPROM
100 women divided into 3 groups:

 -  Group I: included 50 women with preterm premature rupture of membranes (PPROM, n=50)
 with gestational age from 24 to 34 weeks.

 -  Group II: included 25 term non-labor control (T-CTR, n=25) with gestational age from 37
 to 41 weeks.

 -  Group III: included 25 preterm non-labor control (P-CTR, n=25) with gestational age from
 24 to 34 weeks.The myometrial thickness at 4 different sites9:

 a) The lower uterine segment (LUS): 2cm above the reflection of the full urinary bladder
 (b)The anterior wall: 1cm above the maternal umbilicus. (c)Fundus: by placing the scan
 probe perpendicularly above the uterine fundus so that the entire curvature of the
 uterus was visualized.

 (d)The posterior wall: through using the maternal abdominal aortic pulsation as an
 anatomic marker.

 At least 3 measurements were obtained at each site and averaged. The latency interval is
 determined in each of the 3 groups.
The total number of pregnant women enrolled in the study was 100 women. These were divided
 into three groups:

 -  Group I: included 50 women with preterm premature rupture of membranes (PPROM, n=50)
 with gestational age from 24 to 34 weeks.

 -  Group II: included 25 term non-labor control (T-CTR, n=25) with gestational age from 37
 to 41 weeks.

 -  Group III: included 25 preterm non-labor control (P-CTR, n=25) with gestational age from
 24 to 34 weeks.Full History taking, including personal history for maternal age,
 obstetric history for number of previous pregnancies, history of previous PPROM. History
 of present pregnancy included gestational age, history of drug intake with special
 emphasis to women with PPROM giving history of gush of clear watery fluid from the
 vagina. Past history to exclude women with a contra- indication for conservative
 management in the study group.

 Physical examinations: General examination for pulse, arterial blood pressure and temperature
 to exclude any signs of chorioamnionitis in the study group.

 Abdominally, fundal level examinations for predicting the gestational age and/or IUGR or
 abnormalities of liquor. Monitoring of uterine contraction to pick up women who are not in
 labor in the study group.

 P/V examination was not done for the three groups. While definite diagnosis of PPROM relied
 on sterile speculum examination showing a collection of fluid in the vagina. Some women
 needed direct observation of the cervix during a valsulva maneuver or with cough to show free
 flow of fluid from the cervical os.

 Ultrasonographic examination: An abdominal ultrasound for: Estimation of gestational age,
 Assessment of fetal well being by biophysical profile (BPP), Detection of any fetal gross
 anomalies, Assessment of fetal growth to exclude IUGR, Sonographic estimation of fetal weight
 (SEFW), measurement of the Amniotic Fluid Index (AFI), Detection of any abnormal placental
 insertion and/or uterine structural abnormalities as septate or bicornuate uterus, measuring
 The myometrial thickness at 4 different sites9:

 a) The lower uterine segment (LUS): 2cm above the reflection of the full urinary bladder
 (b)The anterior wall: 1cm above the maternal umbilicus. (c)Fundus: by placing the scan probe
 perpendicularly above the uterine fundus so that the entire curvature of the uterus was
 visualized.

 (d)The posterior wall: through using the maternal abdominal aortic pulsation as an anatomic
 marker.

 At least 3 measurements were obtained at each site and averaged. The latency interval is
 determined in each of the 3 groups.
Inclusion Criteria:

 -  singleton pregnancy with a definite history of current PPROM for the study group

 Exclusion Criteria:

 -  Suspected fetal growth restriction (IUGR),

 -  Any gross fetal anomalies,

 -  Abnormalities of placentation,

 -  Uterine structural abnormalities,

 -  Fetal jeopardy or intrauterine fetal death (IUFD).

 -  Women presenting with chorioamniointis with fever over 38 c abdominal tenderness, foul
 vaginal discharge and/or fetal tachycardia.

 -  Diabetics, immunocompromized and cardiac patients.

 -  Women with cervical cerclage.

 -  Women with drained liquor