Abstract
Preterm premature rupture of membranes (PPROM) is defined as the rupture of fetal membranes before 37 weeks. Extreme PPROM occurs before 26 weeks' gestation and can result in perinatal morbidity and mortality. The aim of this study was to study the perinatal outcomes of mothers with extreme PPROM. A retrospective cohort study of 44 consecutive pregnant women, presenting with PPROM before 26 weeks' gestation, was conducted from January 2006 to December 2011 at Sultan Qaboos University Hospital, Oman. Maternal and neonatal information was collected from medical records, and delivery and neonatal unit registries. Women with PPROM presenting after 26 weeks' gestation, those with multiple gestations, or other types of preterm deliveries were excluded from the study. Of the 44 preterm infants admitted to the Neonatal Intensive Care Unit, 24 (55%) survived, 7 (16%) died within 24 hours of birth, 9 (20%) were miscarried, and 4 (9%) were stillbirths. Neonatal sepsis and pulmonary hypoplasia were the major causes of death. Neonatal complications among the surviving infants included prematurity in 11 (46%), respiratory distress syndrome in 19 (79%), sepsis in 12 (50%), and low birth weight in 11 (46%). The neonatal survival rate was significantly associated with the gestational age at delivery but not with the gestational age upon rupture of membranes. Extreme PPROM was associated with adverse perinatal outcomes. The results of this study will help obstetricians and neonatologists in counselling couples experiencing PPROM. Future studies of long-term neonatal morbidity should have larger sample sizes and include more hospitals.
Highlights
Preterm premature rupture of membranes (PPROM) is defined as the rupture of fetal membranes before 37 weeks
The purpose of this study was to look at maternal and fetal outcomes, including the survival rate of the neonates at the Sultan Qaboos University Hospital (SQUH) neonatal intensive care unit (NICU) who were born to mothers with PPROM before 26 weeks’ gestation
This study revealed that neonatal complications and poor outcomes from PPROM before 23 weeks of gestation are high
Summary
Abstract: Objectives: Preterm premature rupture of membranes (PPROM) is defined as the rupture of fetal membranes before 37 weeks. The major cause of neonatal morbidity and mortality is preterm birth It is divided into three categories: preterm premature rupture of membrane (PPROM), preterm labour, and early delivery resulting from medical intervention. PPROM is a serious condition leading to approximately onethird of preterm births and it complicates about 3% of pregnancies.[1] It is associated with many perinatal complications including neonatal sepsis, respiratory distress syndrome (RDS), placental abruption, and eventually fetal death, and carries a 1 to 2% risk of fetal death.[2] In addition, PPROM puts the mother at risk for infection (chorioamnionitis) and premature delivery, and increases the risk of Caesarean section delivery. The purpose of this study was to look at maternal and fetal outcomes, including the survival rate of the neonates at the Sultan Qaboos University Hospital (SQUH) neonatal intensive care unit (NICU) who were born to mothers with PPROM before 26 weeks’ gestation. The results of the study will help obstetricians and neonatologists in counselling couples
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