Neonatal outcome and two-year follow-up after expectant management of second trimester rupture of membranes

Int J Gynaecol Obstet. 2008 Jun;101(3):264-8. doi: 10.1016/j.ijgo.2007.12.007. Epub 2008 Mar 4.

Abstract

Objective: To assess neonatal outcome and 2-year follow-up of pregnancies complicated by second trimester preterm premature rupture of membranes (PPROM).

Methods: A retrospective review of obstetric and neonatal records for 87 pregnancies (56 singletons, 6 twins, 1 triplet) with PPROM between 14+0 and 24+6 weeks of gestation. Patients received antibiotics and steroids for fetal lung maturity once they reached 24 weeks of gestation. Placentas were examined histopathologically. Surviving infants were followed-up at 2 years of age.

Results: Median latency from PPROM to delivery was 4 days. Survival rate of 56 singletons was 45% (25/56); and 13 died in hospital. Survival rate of infants discharged from hospital was 23% (12/56). Chorioamnionitis was seen histologically in 42% (5/12) of surviving infants compared with 92% (12/13) of those that died in hospital. Of the 12 surviving infants, 50% had a normal neurological and developmental outcome at 2 years of age.

Conclusion: Gestational age, birth weight, and histologic chorioamnionitis have prognostic importance in pregnancies complicated by PPROM. Surviving infants have a 50% chance of achieving an adequate health status at 2 years of age.

MeSH terms

  • Adrenal Cortex Hormones
  • Adult
  • Anti-Bacterial Agents / therapeutic use*
  • Chorioamnionitis / drug therapy
  • Female
  • Fetal Death / etiology
  • Fetal Membranes, Premature Rupture / diagnosis
  • Fetal Membranes, Premature Rupture / therapy*
  • Fetal Organ Maturity / drug effects
  • Follow-Up Studies
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Infant, Premature, Diseases / mortality*
  • Medical Records
  • Obstetric Labor, Premature / therapy*
  • Pregnancy
  • Pregnancy Outcome*
  • Pregnancy Trimester, Second*
  • Retrospective Studies
  • Survival Rate
  • Time Factors

Substances

  • Adrenal Cortex Hormones
  • Anti-Bacterial Agents