title: Prolonged premature rupture of membranes in the preterm infant: a 7 year study.
abstract: OBJECTIVE
  To review the outcome of infants born following prolonged and preterm rupture of the membranes.
  
  
  METHODS
  retrospective and partially prospective observational study.
  
  
  METHODS
  babies born in and referred to a tertiary neonatal centre.
  
  
  METHODS
  117 preterm infants, median gestation (range) = 29.5 (25-36) weeks, seen over a 7 year period with membranes ruptured for more than 4 days; median (range) = 9 (4-119) days.
  
  
  METHODS
  survival and cause of death, compression deformities, pulmonary hypoplasia and infection.
  
  
  RESULTS
  23 infants died, 11 from pulmonary hypoplasia and 11 as a direct consequence of prematurity (3 from hyaline membrane disease, 7 from bronchopulmonary dysplasia and one from necrotising enterocolitis developed on day 17). One infant had a lethal congenital abnormality and died untreated of overwhelming infection. No other infants died of infection. 94% of infants were treated with broad-spectrum antibiotics after birth. Compression deformities were seen in 25 infants: median duration of membrane rupture 28 days, range 4-119. In those without deformity, median duration was 7 days, range 4-105. Sixteen infants had pulmonary hypoplasia (median 31, range 14-119), 11 died (median 37, range 21-112) and five survived (median 23, range 14-119). Although the median duration of membrane rupture in infants dying of pulmonary hypoplasia was longer than in those who did not have hypoplasia (31 compared to 7 days), 13 of 27 (48%) of infants whose membranes were ruptured for 4 weeks and 4 of 7 (57%) whose membranes were ruptured more than 70 days survived.
  
  
  CONCLUSIONS
  death from pulmonary hypoplasia is a much more serious problem following preterm prolonged membrane rupture than is infection. Pulmonary hypoplasia is not inevitable even after prolonged periods of membrane rupture.
authors: Department of Child Life and Health, University of Edinburgh, UK.
authors: N
authors: N
authors: McIntosh
authors: A
authors: A
authors: Harrison
mesh_terms: D001424:Bacterial Infections / Q000209:etiology*; D001997:Bronchopulmonary Dysplasia / Q000209:etiology* / Q000401:mortality; D005260:Female; D005322:Premature Rupture of Fetal Membranes; D006801:Humans; D006819:Hyaline Membrane Disease / Q000209:etiology / Q000401:mortality; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D008168:Lung / Q000002:abnormalities*; D011247:Pregnancy; D011446:Prospective Studies; D012189:Retrospective Studies; D015996:Survival Rate