[Comparative study of pregnancy outcome in premature rupture of membranes with amniotic fluid indices of less and more than 5]

Preterm premature rupture of the membranes [PPROM] is one of the most important causes of perinatal morbidity and mortality. The aim of this study was to evaluate pregnancy outcome in preterm premature rupture of the membranes with amniotic fluid index less than 5 and more than 5. This prospective study was performed on 137 pregnant women with gestational age of 28-34 weeks with PPROM from Oct 2006 to Oct 2008. The patients were divided in two groups according to amniotic fluid index: AFI<5 [77cases], AFI >/= 5 [60 cases]. Chi-square test was used for qualitative variables, while T-student test was used for quantitative test. Both groups were similar with respect to number of pregnancies, gestational age at rupture of the membranes and birth weight. In the group with AFI<5, applied latency was significantly shorter [PV=0.049], rate of cesarean section was higher due to fetal distress [PV=0.008], neonatal Apgar score in first minute was lower during the first week [PV=0.0127] and the rate of neonatal death was higher [PV=0.045] during the first week. An AFI<5 cm after PPROM is associated with earlier delivery, higher rate of cesarean due to fetal distress, higher rate of neonatal death, and lower neonatal Apgar score in first minute during the first week

effect of calcium and phosphorus in osteopenia of prematurity

Introduction: Osteopenia is a recognized complication in VLBW infants. In adequate postnatal intake of calcium and phosphorus is probably important in the pathogenesis of bone disease in VLBW infants. This study is carried out to determine the effect of calcium and phosphorus supplementation on prevention of Osteopenia in preterm infants

Material and Methods: In NICU at Ghaem Hospital for a period of one year 43 preterm infants with birth weight less than 2000gr, were followed from birth to six week after birth. Twenty babies [control group] received breast milk and 23 babies [case group] received breast milk and supplemented with calcium and phosphorus. All received a daily supplement of 400U vitamin D. serum calcium, phosphorus and alkaline phosphatase obtained every two weeks until six-weeks postnatal age, at the end of this time wrist x-ray for evaluating of Osteopenia were done

Results: With biochemical criteria 15 patients developed osteopenia, which 7[30.4%] were in the case group and eight [40%] were in the control group. With radiographic criteria 23 patients developed osteopenia which 11[48%] were in the case group and 12[60%] were in the control group, these difference are not significant [P=0.35 and P=0.2]. Linear growth during this period was 5.36cm in the case group versus 4.45cm in the control group, and weight gain was 19.76gr/day in the case group versus 16.61g/day in the control group

Conclusion: Calcium and phosphorus supplementation in VLBW infants that fed breast milk was effective on prevention of osteopenia. In addition this supplementation induced better linear growth and weight gain