Expectant management of preterm premature rupture of membranes: Is it all about gestational age?

Nir Melamed*, Avi Ben-Haroush, Joseph Pardo, Rony Chen, Eran Hadar, Moshe Hod, Yariv Yogev

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVE: We sought to compare neonatal outcome in cases of uncomplicated preterm premature rupture of membranes (PPROM) (ie, no evidence of clinical chorioamnionitis, placental abruption, or fetal distress) with that of spontaneous preterm deliveries (PTDs) and to determine the effect of the latency period. STUDY DESIGN: The study group included women with PPROM at gestational age 280/7-336/7 weeks (n = 488). Neonatal outcome was compared with a matched control group of women with spontaneous PTD (n = 1464). RESULTS: Neonates in the uncomplicated PPROM group were at increased risk for composite adverse outcome (53.7% vs 42.0%; P < .001), mortality (1.6% vs 0.0%; P < .001), respiratory morbidity (32.8% vs 26.4%; P = .006), necrotizing enterocolitis, jaundice, hypoglycemia, hypothermia, and polycythemia. Neonatal adverse outcome was more likely in cases of latency period >7 days, oligohydramnios, male fetus, and nulliparity. CONCLUSION: Consultation regarding prematurity-related morbidity in infants exposed to uncomplicated PPROM cannot be extrapolated from PTDs and should be stratified by the duration of the latency period and the other risk factors identified in the current study.

Original languageEnglish
Pages (from-to)48.e1-48.e8
JournalAmerican Journal of Obstetrics and Gynecology
Volume204
Issue number1
DOIs
StatePublished - Jan 2011

Keywords

  • latency
  • neonatal
  • outcome
  • preterm premature rupture of membranes

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