Comparison between hyperechoic and normo-echoic amniotic membranes in patients with preterm premature rupture of membranes regarding pregnancy outcome.

Purpose: To evaluate the amniotic membrane echogenicity as a marker of early delivery among pregnant women presenting with leakage of amniotic fluid.

Methods: This prospective cohort study was commenced at the Obstetrics and Gynecology Department at Suez Canal University Hospital from March 2023 to March 2024. The study recruited 72 pregnant females aged 20-45 years with singleton pregnancies and presented with preterm leakage of amniotic fluid. The gestational age was between 28 and 37 weeks. The sonographic appearance of the amniotic membranes close to the internal os was evaluated using transvaginal ultrasound. The membranes were classified as hyperechoic when they showed echogenic similarity to the fetal bones (either skull, femur, or pelvic bones) or normo-echoic. The primary outcome measures were the time interval from admission to delivery and the incidence of spontaneous preterm labor.

Results: The mean age of patients was 26.06 years old, with mean gestational age at hospital entry 32.47, with no statistically significant difference between hyperechoic and normo-echoic membranes groups. The admission to delivery time was longer among the normo-echoic group (20 days versus 7.1 days, p value = 0.001). The incidence of spontaneous preterm delivery was 71.9% in the hyperechoic membranes group versus 50% in the normo-echoic membrane group.

Conclusion: The existence of fetal membranes with increased echogenicity overriding the cervix could anticipate an unavoidable preterm birth in patients diagnosed with preterm premature rupture of membranes.