[Spontaneous rupture of the membranes before 28 weeks of amenorrhea. Obstetrical and perinatal outcome. Apropos of 28 cases].
The authors studied the outcome of pregnancies after spontaneous rupture of the membranes before 28 weeks of amenorrhoea in a series of 28 women. The mean time of the rupture was at 25 1/2 weeks. The duration of the time of rupture was a mean of 10 days and deliveries occurred between the 19th and the 32nd weeks. In 5 cases with an average term of 22 1/2 weeks the pregnancy was terminated. Caesarean operation was carried out in 4 cases and spontaneous vaginal delivery occurred between the 26th and 30th weeks of amenorrhoea in 19 cases. Chorio-amnionitis was the most common maternal complication (32.1%). Maternal morbidity was high (82%) without important sequelae. Thirty infants were born out of these 28 pregnancies (two sets of twins). 33% of the infants were stillborn, 46.6% died in the neonatal period, all of these from respiratory complications. 20% of the children are still alive, and all of these weighed at least 1,000 grams and were born after 28 weeks. A child that was born at 27 weeks amenorrhoea has serious neurological deficits. Having studied the bibliography on the subject and their own personal experience the authors suggest a routine to carry out in these cases. Although the prognosis is poor, the totality of these factors could encourage obstetrical teams to be conservative so long as they watch very carefully under well defined conditions.
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Département de Gynécologie-Obstétrique et de la Reproduction, CHU Bretonneau, Tours.
Forveille
F
F
Lemseffer
J
J
Kone
M
M
Pierre
F
F
Lansac
J
J
Soutoul
J H
JH
Berger
C
C
D000293:Adolescent; D000328:Adult; D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D005260:Female; D005313:Fetal Death / Q000453:epidemiology; D005322:Premature Rupture of Fetal Membranes / Q000150:complications / Q000453:epidemiology* / Q000628:therapy; D005602:France / Q000453:epidemiology; D005865:Gestational Age; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007234:Infant, Premature; D007743:Labor, Obstetric; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology; D011256:Pregnancy Outcome / Q000453:epidemiology*; D012307:Risk Factors; D013997:Time Factors