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Outcome of pregnancies with preterm prelabor rupture of membranes before 27 weeks' gestation: a retrospective cohort study.
Eur J Obstet Gynecol Reprod Biol. 2013 Sep; 170(1):125-30.EJ

Abstract

OBJECTIVE

Preterm prelabor rupture of membranes (PPROM) before 27 weeks' gestation is associated with severe perinatal complications, but quantitative estimates are lacking. The aim of this study was to report and predict outcomes of pregnancies complicated by early PPROM and to study antepartum risk factors that might predict perinatal death in future patients.

STUDY DESIGN

We performed a retrospective cohort study of women with PPROM between 13(+0) weeks and 27(+0) weeks' gestation between 1994 and 2009 in three perinatal centers.

MAIN OUTCOME MEASURES

Perinatal mortality, composite neonatal morbidity and premature delivery. A model to predict these outcomes was developed from antepartum variables.

RESULTS

We identified 314 women with PPROM before 27 weeks, including 28 multiple pregnancies. Six pregnancies (2%) were terminated before 24 weeks' gestation, and three were lost to follow up, leaving 305 pregnancies for analysis. Overall, there were 166 perinatal deaths (49%). The perinatal mortality rate decreased with increasing gestational age at PPROM (from 70% in the group PPROM 13-20 weeks to 27% in the group PPROM 24-27 weeks). Of the 170 surviving neonates, 70 suffered from serious morbidity (41%). Early gestational age at PPROM, long interval between PPROM and birth and positive vaginal culture (any bacteria) were associated with perinatal mortality.

CONCLUSION

Perinatal mortality in PPROM before 27 weeks occurred in half of the cases and among those who survive approximately 40% suffered serious morbidity. Antenatal parameters can be helpful to predict perinatal mortality.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, Maastricht University Medical Centre, GROW - School for Oncology and Developmental Biology, The Netherlands. Electronic address: JvHeijden84@hotmail.com.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23845169

Citation

van der Heyden, Jantien L., et al. "Outcome of Pregnancies With Preterm Prelabor Rupture of Membranes Before 27 Weeks' Gestation: a Retrospective Cohort Study." European Journal of Obstetrics, Gynecology, and Reproductive Biology, vol. 170, no. 1, 2013, pp. 125-30.
van der Heyden JL, van der Ham DP, van Kuijk S, et al. Outcome of pregnancies with preterm prelabor rupture of membranes before 27 weeks' gestation: a retrospective cohort study. Eur J Obstet Gynecol Reprod Biol. 2013;170(1):125-30.
van der Heyden, J. L., van der Ham, D. P., van Kuijk, S., Notten, K. J., Janssen, T., Nijhuis, J. G., Willekes, C., Porath, M., van der Post, J. A., Halbertsma, F., Mol, B. W., & Pajkrt, E. (2013). Outcome of pregnancies with preterm prelabor rupture of membranes before 27 weeks' gestation: a retrospective cohort study. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 170(1), 125-30. https://doi.org/10.1016/j.ejogrb.2013.06.012
van der Heyden JL, et al. Outcome of Pregnancies With Preterm Prelabor Rupture of Membranes Before 27 Weeks' Gestation: a Retrospective Cohort Study. Eur J Obstet Gynecol Reprod Biol. 2013;170(1):125-30. PubMed PMID: 23845169.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Outcome of pregnancies with preterm prelabor rupture of membranes before 27 weeks' gestation: a retrospective cohort study. AU - van der Heyden,Jantien L, AU - van der Ham,David P, AU - van Kuijk,Sander, AU - Notten,Kim J B, AU - Janssen,Timothy, AU - Nijhuis,Jan G, AU - Willekes,Christine, AU - Porath,Martina, AU - van der Post,Joris A, AU - Halbertsma,Feico, AU - Mol,Ben Willem J, AU - Pajkrt,Eva, Y1 - 2013/07/08/ PY - 2012/10/30/received PY - 2013/05/03/revised PY - 2013/06/08/accepted PY - 2013/7/13/entrez PY - 2013/7/13/pubmed PY - 2014/6/3/medline KW - Midtrimester PPROM KW - Neonatal morbidity KW - Perinatal mortality KW - Preterm birth KW - Preterm rupture of membranes SP - 125 EP - 30 JF - European journal of obstetrics, gynecology, and reproductive biology JO - Eur. J. Obstet. Gynecol. Reprod. Biol. VL - 170 IS - 1 N2 - OBJECTIVE: Preterm prelabor rupture of membranes (PPROM) before 27 weeks' gestation is associated with severe perinatal complications, but quantitative estimates are lacking. The aim of this study was to report and predict outcomes of pregnancies complicated by early PPROM and to study antepartum risk factors that might predict perinatal death in future patients. STUDY DESIGN: We performed a retrospective cohort study of women with PPROM between 13(+0) weeks and 27(+0) weeks' gestation between 1994 and 2009 in three perinatal centers. MAIN OUTCOME MEASURES: Perinatal mortality, composite neonatal morbidity and premature delivery. A model to predict these outcomes was developed from antepartum variables. RESULTS: We identified 314 women with PPROM before 27 weeks, including 28 multiple pregnancies. Six pregnancies (2%) were terminated before 24 weeks' gestation, and three were lost to follow up, leaving 305 pregnancies for analysis. Overall, there were 166 perinatal deaths (49%). The perinatal mortality rate decreased with increasing gestational age at PPROM (from 70% in the group PPROM 13-20 weeks to 27% in the group PPROM 24-27 weeks). Of the 170 surviving neonates, 70 suffered from serious morbidity (41%). Early gestational age at PPROM, long interval between PPROM and birth and positive vaginal culture (any bacteria) were associated with perinatal mortality. CONCLUSION: Perinatal mortality in PPROM before 27 weeks occurred in half of the cases and among those who survive approximately 40% suffered serious morbidity. Antenatal parameters can be helpful to predict perinatal mortality. SN - 1872-7654 UR - https://www.unboundmedicine.com/medline/citation/23845169/Outcome_of_pregnancies_with_preterm_prelabor_rupture_of_membranes_before_27_weeks'_gestation:_a_retrospective_cohort_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0301-2115(13)00272-8 DB - PRIME DP - Unbound Medicine ER -