Risks of Preterm Premature Rupture of Membranes and Preterm Birth Post Fetoscopy Based on Location of Trocar Insertion Site.

Abstract:

OBJECTIVE:The objective of this study was to assess whether the location of the trocar insertion site for laser treatment of twin-twin transfusion syndrome was associated with preterm-premature rupture of membranes (PPROM) and preterm birth (PTB). STUDY DESIGN:In this study trocar location was documented in the operating room. Lower uterine segment (LUS) location was defined as any insertion <10 cm vertically from the pubic symphysis. Lateral location was defined as ≥5 cm horizontally from the midline. Patient characteristics were tested against three outcomes: PPROM ≤ 21 days postoperative, PTB < 28 weeks, and PTB < 32 weeks. For each outcome, multiple logistic models were fitted to examine the effect of trocar location, controlling for potential risk factors. RESULTS:A total of 743 patients were studied. Patients with LUS location were twice as likely as those with a more superior location to have PPROM ≤ 21 days (OR = 2.33, 1.12-4.83, p = 0.0236). Patients with both a LUS and Lateral location were over six times more likely to have PPROM ≤ 21 days (OR = 6.66, 2.36-18.78, p = 0.0003). Trocar insertion site was not associated with PTB. CONCLUSION:We found that trocar insertion in the LUS, particularly the lateral LUS, was associated with an increased risk of PPROM.

journal_name

Am J Perinatol

authors

Chmait RH,Chon AH,Korst LM,Llanes A,Kontopoulos EV,Quintero RA

doi

10.1055/s-0037-1620268

subject

Has Abstract

pub_date

2018-07-01 00:00:00

pages

801-808

issue

8

eissn

0735-1631

issn

1098-8785

journal_volume

35

pub_type

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