Outcome of pregnancies with spontaneous PPROM before 24+0 weeks' gestation

Abstract

Objective: To examine the contemporary outcome in women with rupture of membranes (PPROM) before 24+0 weeks' gestation.

Study design: Retrospective analysis of women with spontaneous PPROM before 24+0 weeks that were treated at the University of Tuebingen/Germany. The search of the database included common maternal and pregnancy characteristics as well as the neonatal outcomes.

Results: One hundred and one pregnancies fulfilled the inclusion criteria. 32 (31.7%) women opted for termination of pregnancy, which were excluded from further analysis. The gestational age at PPROM in the 69 women with an expectant management was 21.3 (IQR 19.1-22.6) weeks. 40 (58.0%) pregnancies carried on beyond 24+0 weeks. Multiple regression analysis indicated that the time of PPROM and the absence of oligo-/anhydramnios were associated with a prolongation beyond 24+0 weeks. In the 40 pregnancies that remained intact beyond 24+0 weeks' gestation, the fetuses were born at 27.7 (IQR 25.3-30.9) weeks. Survival without major complications was observed in 22 (55.0%) fetuses. Multiple regression analysis indicated that only the gestational age at the time of delivery was significantly associated with such an intact survival.

Conclusion: In cases with PPROM there is a 60% chance of a prolongation beyond 24+0 weeks. About half of these fetuses will be discharged alive without major complications.

Keywords: Neonatal; Outcome; PPROM; Prenatal; Viability.