Tags

Type your tag names separated by a space and hit enter

Maternal and neonatal outcomes following expectant management of preterm prelabor rupture of membranes before viability.
J Matern Fetal Neonatal Med. 2020 Feb; 33(4):533-541.JM

Abstract

Purpose:

To provide center-based outcome data on obstetric and neonatal complications arising from expectantly managed pregnancies affected by preterm prelabor rupture of membranes (PPROM) before viability.Materials and methods: We collected data on 130 consecutive pregnancies complicated by spontaneous rupture of membranes before 24 week's gestation, occurring over a 7-year period. These were women who delivered >24 h after membrane rupture, and had no signs of chorioamnionitis or advanced labor at admission. Women with amniocentesis-induced PPROM (n = 7) were analyzed separately. The descriptive statistics of obstetrics and neonatal outcomes were reported.

Results:

The overall neonatal survival to discharge rate was 33.8%. Stratification of patients into early (12 to 19+6 weeks' gestation) and late pre-viable PPROM (20 to 23+6 weeks' gestation) revealed a 3.6-fold increase in survival rate in the latter group (12.2% versus 43.8%, p < .001). Pre-viable PPROM following amniocentesis predicted a 100% survival outcome, however anhydramnios impacted negatively. The most common neonatal morbidities of those admitted to intensive care unit were respiratory distress syndrome (78.7%) and bronchopulmonary dysplasia (84.4%). The most common maternal morbidities affecting pre-viable PPROM were clinical chorioamnionitis (47.7%), histological chorioamnionitis (81.8%), retained products of conception (39.3%) and preterm labor (45.4%).

Conclusions:

Later gestational ages at PPROM were associated with better survival rates, however neonatal morbidity remained high. Women experiencing pre-viable PPROM following amniocentesis can be reassured, while those with anhydramnios at any time during the latency period should be adequately counseled regarding poorer outcomes.

Authors+Show Affiliations

Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, VIC, Australia. Pregnancy Research Centre, Royal Women's Hospital, Melbourne, VIC, Australia.Pregnancy Research Centre, Royal Women's Hospital, Melbourne, VIC, Australia.Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, VIC, Australia. Pregnancy Research Centre, Royal Women's Hospital, Melbourne, VIC, Australia.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29961407

Citation

Sim, Winnie Huiyan, et al. "Maternal and Neonatal Outcomes Following Expectant Management of Preterm Prelabor Rupture of Membranes Before Viability." The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, vol. 33, no. 4, 2020, pp. 533-541.
Sim WH, Ng H, Sheehan P. Maternal and neonatal outcomes following expectant management of preterm prelabor rupture of membranes before viability. J Matern Fetal Neonatal Med. 2020;33(4):533-541.
Sim, W. H., Ng, H., & Sheehan, P. (2020). Maternal and neonatal outcomes following expectant management of preterm prelabor rupture of membranes before viability. The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, 33(4), 533-541. https://doi.org/10.1080/14767058.2018.1495706
Sim WH, Ng H, Sheehan P. Maternal and Neonatal Outcomes Following Expectant Management of Preterm Prelabor Rupture of Membranes Before Viability. J Matern Fetal Neonatal Med. 2020;33(4):533-541. PubMed PMID: 29961407.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Maternal and neonatal outcomes following expectant management of preterm prelabor rupture of membranes before viability. AU - Sim,Winnie Huiyan, AU - Ng,Hamon, AU - Sheehan,Penelope, Y1 - 2018/08/13/ PY - 2018/7/3/pubmed PY - 2020/6/6/medline PY - 2018/7/3/entrez KW - Midtrimester PPROM KW - latency KW - maternal outcomes KW - neonatal survival KW - periviable KW - preterm birth KW - preterm prelabor rupture of membranes KW - previable SP - 533 EP - 541 JF - The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians JO - J. Matern. Fetal. Neonatal. Med. VL - 33 IS - 4 N2 - Purpose: To provide center-based outcome data on obstetric and neonatal complications arising from expectantly managed pregnancies affected by preterm prelabor rupture of membranes (PPROM) before viability.Materials and methods: We collected data on 130 consecutive pregnancies complicated by spontaneous rupture of membranes before 24 week's gestation, occurring over a 7-year period. These were women who delivered >24 h after membrane rupture, and had no signs of chorioamnionitis or advanced labor at admission. Women with amniocentesis-induced PPROM (n = 7) were analyzed separately. The descriptive statistics of obstetrics and neonatal outcomes were reported.Results: The overall neonatal survival to discharge rate was 33.8%. Stratification of patients into early (12 to 19+6 weeks' gestation) and late pre-viable PPROM (20 to 23+6 weeks' gestation) revealed a 3.6-fold increase in survival rate in the latter group (12.2% versus 43.8%, p < .001). Pre-viable PPROM following amniocentesis predicted a 100% survival outcome, however anhydramnios impacted negatively. The most common neonatal morbidities of those admitted to intensive care unit were respiratory distress syndrome (78.7%) and bronchopulmonary dysplasia (84.4%). The most common maternal morbidities affecting pre-viable PPROM were clinical chorioamnionitis (47.7%), histological chorioamnionitis (81.8%), retained products of conception (39.3%) and preterm labor (45.4%).Conclusions: Later gestational ages at PPROM were associated with better survival rates, however neonatal morbidity remained high. Women experiencing pre-viable PPROM following amniocentesis can be reassured, while those with anhydramnios at any time during the latency period should be adequately counseled regarding poorer outcomes. SN - 1476-4954 UR - https://www.unboundmedicine.com/medline/citation/29961407/Maternal_and_neonatal_outcomes_following_expectant_management_of_preterm_prelabor_rupture_of_membranes_before_viability_ L2 - http://www.tandfonline.com/doi/full/10.1080/14767058.2018.1495706 DB - PRIME DP - Unbound Medicine ER -