Umbilical artery velocimetry and fetal biophysical profile in preterm premature rupture of the membranes- noninvasive early predictors of placental inflammation

ABSTRACT

this study was designed to evaluate the role of umbilical artery velocimetry and fetal biophysical rofile [BP] Iin npredicting placental inflammation in patients with preterm premature rupture of the membranes [PROM]. Study design: Fifty singletone pregnant patients at 30-34 weeks gestation with preterm PROM were followed up with daily BPP and umbilical artery Systolic/Diastolic [SD] ratio. After delivery, histological examination of the placentas resulted in the assignment of 18 patients to group I [no inflammation] and 26 patients to group II [numbilical vasculitis]. Six patients with placental inflammation confirmed only to the maternal surface were excluded. Cord PH were assessed for all neonates. the longitudinal trends of fetal BPP scores and S/D ratios from day 7 to day 2 before delivery showed no significant changes in either groups. In the last examination. Day one before delivery, patients with placental inflammation showed significantly lower mean BPP score concomitant with significantly higher mean S/D ratio value as compared with the previous examination. There were no significant differences between the two groups in terms of BPP score and S/D ratio except for the last examination before delivery. An abrupt increase of 15% in S/D ratio over the previous examination yielded a sensitive sign for prediction of acute histologic chorioamnionitis. it can be concluded that an abnormal BPP score along with an abruipt rise in numbilical SD ratio may be useful as simple noninvasive reliable tools for early prediction of placental inflammation in patients with preterm PROM. Using both tests together on daily basis is more sensitive and accurate than either alone