Contemporary management of preterm premature rupture of membranes: determinants of latency and neonatal outcome.
Preterm premature rupture of membranes (PPROM) is responsible for 30% of neonatal morbidity and mortality in premature gestations. We sought to evaluate pregnancy outcomes in PPROM managed uniformly with antibiotics and steroids, and to determine what maternal factors influence latency. This was a retrospective analysis of 134 patients at 24 to 31.9 weeks with PPROM. Associations of maternal and pregnancy characteristics with latency were evaluated by chi-square for linear trend, nonparametric tests, or multivariable linear regression, as appropriate. Forty-three of 134 women (32%) had latencies greater than a week. Gestational age ( p < 0.001), admission white blood cell count ( p = 0.001), and amniotic fluid index ( p = 0.02) were independently predictive of latency. Histopathologic funisitis increased with pregnancy length. There were no fetal deaths or significant intraventricular hemorrhage past 28 weeks.
Gopalani
Sameer
S
Departments of Obstetrics, Gynecology, and Reproductive of Sciences, Magee-Womens Hospital of the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Krohn
Marijane
M
Meyn
Leslie
L
Hitti
Jane
J
Crombleholme
William R
WR
D000328:Adult; D016009:Chi-Square Distribution; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000188:drug therapy* / Q000503:physiopathology* / Q000517:prevention & control; D005865:Gestational Age; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000209:etiology; D016014:Linear Models; D008429:Maternal Welfare; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors