[Premature rupture of the membranes between 28 and 34 weeks of amenorrhea. Retrospective study apropos of 71 cases].
OBJECTIVE
The aim of our study is to compare the outcome of infants born after preterm premature rupture of the membranes (PPROM) between 28 and 34 weeks gestation. We compare two groups of infants: group A, infants born in hospitals without neonatal intensive care unit, after PPROM with long tocolysis, no maternal prophylactic antibiotic therapy and no systematic maternal steroid therapy. Group B with systematic maternal steroid therapy, maternal prophylactic antibiotic therapy, short tocolysis and born in an hospital with neonatal intensive care unit. The latency period (time from rupture of membranes to the onset of labor) authorized was 15 days in the group B and not limited in the group A.


RESULTS
Death (13.8% vs 0%; p=0.022), neonatal infection (66.6% vs 28.6%; p=0.0013), and respiratory distress (63.8% vs 34.3%; p=0.0144) were less frequent in the group B. The group A infants passed more than ten days in intensive care unit (61.1% vs 37.1%; p=0.043). Neonatal infection was not higher in the corticosteroïd therapy group (41.2% vs 70.3%; p=0.0135). There is more neonatal infection in the group A with long latency period (61.7% vs 24.3%; p=0.0014) and more chorioamnionitis (70.6% vs 24.3%; p<0.0001).


CONCLUSIONS
The association maternal steroid and antibiotic therapy, short latency period, and hospitalization of the pregnant woman close to a neonatal intensive care unit reduce significantly the neonatal morbidity after preterm premature rupture of the membranes.
Mehdi
A
A
Département de Gynécologie-Obstétrique Médecine de la Reproduction, CHU de Saint-Etienne, Hôpital Nord, 42055 Saint-Etienne cedex 2.
Collet
F
F
Aiguier
M
M
Miras
T
T
Teyssier
G
G
Seffert
P
P
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000453:epidemiology / Q000517:prevention & control; D002821:Chorioamnionitis / Q000453:epidemiology; D005260:Female; D005313:Fetal Death / Q000453:epidemiology; D005322:Premature Rupture of Fetal Membranes / Q000150:complications; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal; D011247:Pregnancy; D011256:Pregnancy Outcome; D012127:Respiratory Distress Syndrome, Newborn / Q000453:epidemiology; D012189:Retrospective Studies; D015145:Tocolysis
D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents