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Maternal and neonatal outcomes following expectant management of preterm prelabour rupture of membranes before viability.
J Perinat Med. 2017 Jan 01; 45(1):29-44.JP

Abstract

AIM

To assess the contemporary maternal and neonatal outcomes following expectant management of preterm premature rupture of membranes (PPROM) prior to 24 weeks' gestation and to identify prognostic indicators of this morbid presentation.

METHODS

We performed a systematic review in the Pubmed and EMBASE databases to identify the primary (perinatal mortality, severe neonatal morbidity and serious maternal morbidity) and secondary (neonatal survival and morbidity) outcomes following expectant management of previable PPROM.

RESULTS

Mean latency between PPROM and delivery ranged between 20 and 43 days. Women with PPROM <24 weeks had an overall live birth rate of 63.6% and a survival-to-discharge rate of 44.9%. The common neonatal morbidities were respiratory distress syndrome, bronchopulmonary dysplasia and sepsis. The majority of neonatal deaths within 24 h post birth were associated with pulmonary hypoplasia, severe intraventricular haemorrhage and neonatal sepsis. The common maternal outcomes were chorioamnionitis and caesarean sections. The major predictors of neonatal survival were later gestational age at PPROM, adequate residual amniotic fluid levels, C-reactive protein <1 mg/dL within 24 h of admission and PPROM after invasive procedures.

CONCLUSION

Pregnancy latency and neonatal survival following previable PPROM has improved in recent years, although neonatal morbidity remains unchanged despite recent advances in obstetric and neonatal care. There is heterogeneity in management practices across centres worldwide.

Authors

No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review
Systematic Review

Language

eng

PubMed ID

27780154

Citation

Sim, Winnie Huiyan, et al. "Maternal and Neonatal Outcomes Following Expectant Management of Preterm Prelabour Rupture of Membranes Before Viability." Journal of Perinatal Medicine, vol. 45, no. 1, 2017, pp. 29-44.
Sim WH, Araujo Júnior E, Da Silva Costa F, et al. Maternal and neonatal outcomes following expectant management of preterm prelabour rupture of membranes before viability. J Perinat Med. 2017;45(1):29-44.
Sim, W. H., Araujo Júnior, E., Da Silva Costa, F., & Sheehan, P. M. (2017). Maternal and neonatal outcomes following expectant management of preterm prelabour rupture of membranes before viability. Journal of Perinatal Medicine, 45(1), 29-44. https://doi.org/10.1515/jpm-2016-0183
Sim WH, et al. Maternal and Neonatal Outcomes Following Expectant Management of Preterm Prelabour Rupture of Membranes Before Viability. J Perinat Med. 2017 Jan 1;45(1):29-44. PubMed PMID: 27780154.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Maternal and neonatal outcomes following expectant management of preterm prelabour rupture of membranes before viability. AU - Sim,Winnie Huiyan, AU - Araujo Júnior,Edward, AU - Da Silva Costa,Fabricio, AU - Sheehan,Penelope Marie, PY - 2016/05/24/received PY - 2016/09/29/accepted PY - 2016/10/26/pubmed PY - 2017/7/18/medline PY - 2016/10/26/entrez SP - 29 EP - 44 JF - Journal of perinatal medicine JO - J Perinat Med VL - 45 IS - 1 N2 - AIM: To assess the contemporary maternal and neonatal outcomes following expectant management of preterm premature rupture of membranes (PPROM) prior to 24 weeks' gestation and to identify prognostic indicators of this morbid presentation. METHODS: We performed a systematic review in the Pubmed and EMBASE databases to identify the primary (perinatal mortality, severe neonatal morbidity and serious maternal morbidity) and secondary (neonatal survival and morbidity) outcomes following expectant management of previable PPROM. RESULTS: Mean latency between PPROM and delivery ranged between 20 and 43 days. Women with PPROM <24 weeks had an overall live birth rate of 63.6% and a survival-to-discharge rate of 44.9%. The common neonatal morbidities were respiratory distress syndrome, bronchopulmonary dysplasia and sepsis. The majority of neonatal deaths within 24 h post birth were associated with pulmonary hypoplasia, severe intraventricular haemorrhage and neonatal sepsis. The common maternal outcomes were chorioamnionitis and caesarean sections. The major predictors of neonatal survival were later gestational age at PPROM, adequate residual amniotic fluid levels, C-reactive protein <1 mg/dL within 24 h of admission and PPROM after invasive procedures. CONCLUSION: Pregnancy latency and neonatal survival following previable PPROM has improved in recent years, although neonatal morbidity remains unchanged despite recent advances in obstetric and neonatal care. There is heterogeneity in management practices across centres worldwide. SN - 1619-3997 UR - https://www.unboundmedicine.com/medline/citation/27780154/Maternal_and_neonatal_outcomes_following_expectant_management_of_preterm_prelabour_rupture_of_membranes_before_viability_ L2 - https://www.degruyter.com/doi/10.1515/jpm-2016-0183 DB - PRIME DP - Unbound Medicine ER -