Outcomes after expectant management of extremely preterm premature rupture of the membranes.
OBJECTIVE
This study was undertaken to assess contemporary outcomes in pregnancies managed expectantly after extremely preterm premature (< or =24 weeks) premature rupture of the membranes (EPPROM).


METHODS
We queried antepartum and ultrasound databases for patients with EPPROM. Data on pregnancy outcome and short-term neonatal outcomes were collected.


RESULTS
Forty-six patients with EPPROM were studied. Patients were hospitalized at 24 weeks' gestation and given antibiotics and antenatal steroids. Median gestational age at PPROM was 22.0 weeks (range 16.9-24 weeks); 43 (93%) elected expectant management, 2 of whom later had an intrauterine fetal death. Median latency period to delivery was 13 days (range 0-96 days), with mean gestational age at delivery of 25.8+/-3.4 weeks. Overall survival was 47% (27 of 57 infants), after a median hospital stay of 71 days (range 17-209 days). Ten (37%) of the survivors have serious sequelae.


CONCLUSIONS
Although significant pregnancy prolongation after previable PPROM occurs in many cases, neonatal outcomes remain poor.
Dinsmoor
Mara J
MJ
Department of Obstetrics and Gynecology, Evanston Hospital, Evanston Northwestern Healthcare, Evanston, IL, USA.
Bachman
Rebecca
R
Haney
Elaine I
EI
Goldstein
Marci
M
Mackendrick
William
W
D000328:Adult; D016208:Databases, Factual; D036861:Delivery, Obstetric; D005260:Female; D005313:Fetal Death; D005322:Premature Rupture of Fetal Membranes / Q000628:therapy*; D005865:Gestational Age; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007902:Length of Stay; D011247:Pregnancy; D011256:Pregnancy Outcome; D011272:Pregnancy, Multiple; D013997:Time Factors