717: Rates and predictors of placental abruption during expectant management of PPROM < 32 weeks: analysis by gestational age at rupture

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ObjectivePrevious studies reported increased risk of placental abruption (PA) in PPROM, and this risk was increased with chorioamnionitis (CA) or prolonged latency period. Most studies were reported prior to routine use of corticosteroids and latency antibiotics. Our objective is to determine the rate of PA per gestational age (GA) at rupture and to identify predictors of PA during expectant management (EM) of PPROM < 32 weeks.Study DesignSecondary analysis of a multicenter trial of magnesium sulfate (MS) for prevention of cerebral palsy. Women with singleton gestation and PPROM < 32 wks receiving universal corticosteroids and latency antibiotics were studied. Rates and clinical risk factors for PA by GA at PROM were evaluated: maternal age, parity, ethnicity, smoking/drug abuse, use of MS, CA, vaginal bleeding, and latency period. Univariate and multivariate analyses were performed.Results1760 patients were studied: < 24 wk (n = 139), 24 to 26 (n = 368), 26-28 (n = 347), 28-30 (n = 430), 30-32 (n = 473). PA was diagnosed in 139 patients (8%). The rate of PA was dependent on GA at rupture, the highest in < 24 wks and lowest at 30 to 32 wks (fig). Maternal ethnicity/race, parity, first trimester bleeding, latency period, and exposure to MS did not affect the rate of PA. Multivariate analysis revealed that factors predicting PA were CA (aOR 3.88: 95 CI, 1.67-9.0), second/third trimester bleeding (aOR 0.40: 95 CI, 0.26-0.62) and GA at PROM (aOR 0.85: 95 CI, 0.79-0.91).Conclusion ObjectivePrevious studies reported increased risk of placental abruption (PA) in PPROM, and this risk was increased with chorioamnionitis (CA) or prolonged latency period. Most studies were reported prior to routine use of corticosteroids and latency antibiotics. Our objective is to determine the rate of PA per gestational age (GA) at rupture and to identify predictors of PA during expectant management (EM) of PPROM < 32 weeks. Previous studies reported increased risk of placental abruption (PA) in PPROM, and this risk was increased with chorioamnionitis (CA) or prolonged latency period. Most studies were reported prior to routine use of corticosteroids and latency antibiotics. Our objective is to determine the rate of PA per gestational age (GA) at rupture and to identify predictors of PA during expectant management (EM) of PPROM < 32 weeks. Study DesignSecondary analysis of a multicenter trial of magnesium sulfate (MS) for prevention of cerebral palsy. Women with singleton gestation and PPROM < 32 wks receiving universal corticosteroids and latency antibiotics were studied. Rates and clinical risk factors for PA by GA at PROM were evaluated: maternal age, parity, ethnicity, smoking/drug abuse, use of MS, CA, vaginal bleeding, and latency period. Univariate and multivariate analyses were performed. Secondary analysis of a multicenter trial of magnesium sulfate (MS) for prevention of cerebral palsy. Women with singleton gestation and PPROM < 32 wks receiving universal corticosteroids and latency antibiotics were studied. Rates and clinical risk factors for PA by GA at PROM were evaluated: maternal age, parity, ethnicity, smoking/drug abuse, use of MS, CA, vaginal bleeding, and latency period. Univariate and multivariate analyses were performed. Results1760 patients were studied: < 24 wk (n = 139), 24 to 26 (n = 368), 26-28 (n = 347), 28-30 (n = 430), 30-32 (n = 473). PA was diagnosed in 139 patients (8%). The rate of PA was dependent on GA at rupture, the highest in < 24 wks and lowest at 30 to 32 wks (fig). Maternal ethnicity/race, parity, first trimester bleeding, latency period, and exposure to MS did not affect the rate of PA. Multivariate analysis revealed that factors predicting PA were CA (aOR 3.88: 95 CI, 1.67-9.0), second/third trimester bleeding (aOR 0.40: 95 CI, 0.26-0.62) and GA at PROM (aOR 0.85: 95 CI, 0.79-0.91). 1760 patients were studied: < 24 wk (n = 139), 24 to 26 (n = 368), 26-28 (n = 347), 28-30 (n = 430), 30-32 (n = 473). PA was diagnosed in 139 patients (8%). The rate of PA was dependent on GA at rupture, the highest in < 24 wks and lowest at 30 to 32 wks (fig). Maternal ethnicity/race, parity, first trimester bleeding, latency period, and exposure to MS did not affect the rate of PA. Multivariate analysis revealed that factors predicting PA were CA (aOR 3.88: 95 CI, 1.67-9.0), second/third trimester bleeding (aOR 0.40: 95 CI, 0.26-0.62) and GA at PROM (aOR 0.85: 95 CI, 0.79-0.91). Conclusion