Perinatal Outcomes Following Prolonged Preterm Premature Rupture of Membranes before Limit of Viability - A Single Center Experience

Abstract

Objective: To investigate maternal and neonatal outcomes following prolonged preterm premature rupture of membrane (PPROM) before limit of viability in a single center. Methods: Thirty-two women with PPROM before 25 weeks'' gestation without overt intrauterine infection were administered expectant management. We investigated maternal and neonatal outcomes of pregnancies following PPROM occurring before 25 weeks’ gestation and with latent period (from membrane rupture to delivery) of 7 days or more. Results: Median gestational age at membrane rupture was 22.1 weeks. Median latent period was 32 days. Median gestational age at delivery was 26.6 weeks. The incidence of clinical pulmonary hypoplasia and early onset sepsis was 43.5% (10/23) and 21.7% (5/23), respectively. The overall mortality in neonatal intensive care unit (NICU) was 43.5% (10/23). Latent period was negatively correlated with gestational age at membrane rupture (r=-0.501, P=0.015), but not associated with maternal complications. As the length of latent period increased, overall mortality in NICU decreased (relative risk=0.898, P=0.011). Conclusion: The expectant management in women with PPROM before 25 weeks'' gestation did not induce maternal complications and might help to improve the neonatal outcomes rather than the immediate delivery.