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Updated: Mar 10, 2026
Transcutaneous Microcirculatory Imaging in Preterm Neonates
Published on: December 31, 2015
Fetal membrane imaging and the prediction of preterm birth: a systematic review, current issues, and future
Vanessa Nunes1, Jennifer Cross1, John E Speich2
1Department of Obstetrics & Gynecology, Virginia Commonwealth University, Richmond, VA, USA.
Insights
Currently, there is insufficient data to link fetal membrane thickness to preterm premature rupture of membranes (PPROM) using ultrasound. Further research with improved methodologies is needed to predict PPROM risk.
Area of Science:
- Obstetrics and Gynecology
- Medical Imaging
- Fetal Medicine
Background:
- Preterm premature rupture of membranes (PPROM) is a leading cause of preterm birth.
- No reliable screening tests exist for PPROM in low-risk, asymptomatic individuals.
- Identifying imaging methods to assess PPROM risk in asymptomatic patients is crucial.
Purpose of the Study:
- To systematically review the literature on fetal membrane thickness for PPROM prediction.
- To evaluate the utility of various imaging techniques in assessing PPROM risk.
Main Methods:
- Systematic literature review focusing on fetal membrane thickness and PPROM prediction.
- Analysis of in vitro and in vivo ultrasound studies with differing methodologies.
- Review of Optical Coherence Tomography (OCT) as an emerging high-resolution imaging technique.
Main Results:
- Current data is insufficient to establish a definitive association between fetal membrane thickness and PPROM prediction via ultrasound.
- Existing studies present varied methodologies, limiting conclusive findings.
Conclusions:
- Fetal membrane thickness holds potential clinical significance for PPROM prediction.
- Improved study designs, larger sample sizes, histological comparisons, and uniform methodologies are recommended.
- Emerging technologies like transvaginal ultrasound, MRI fusion imaging, and Shear Wave Elastography warrant further investigation.
Background:
Preterm premature rupture of membranes (PPROM) is the largest identifiable cause of preterm birth. There is currently no good screening test for PPROM in low-risk asymptomatic patients. Our goal was to identify how imaging methods can be utilized for examining the risks for PPROM in asymptomatic patients.
Methods:
This paper is a systematic review of the literature on fetal membrane thickness and its use for the prediction of PPROM. Four key studies are identified and reviewed; two in vitro studies and two in vivo ultrasound studies each using differing methodologies. Additionally reviewed is a study using Optical Coherence Tomography, an emerging technique using near-infrared technology to produce high-resolution images.
Results:
There is currently insufficient data to determine the association between fetal membrane thickness and PPROM by ultrasound.
Conclusions:
Fetal membrane thickness could have relevant clinical ramifications for the prediction of PPROM. Suggested improvements in study methodology and design will lead to progress in this area of research, as well as the use of newer technologies. Larger sample sizes, histological comparison, uniform methodologies for data collection, longitudinal study design and expanding data analysis beyond fetal membrane thickness to other properties would expand our knowledge in this field. In addition, transvaginal ultrasound should be utilized to improve resolution, as well as emerging methodologies such as MRI fusion imaging using ultrasound and Shear Wave Elastography.
