title: Prevalence, management, and outcomes of preterm prelabour rupture of the membranes of women in Canada.
abstract: OBJECTIVE
  To determine the prevalence of preterm prelabour rupture of the membranes (PPROM) at Canadian university-affiliated perinatal referral centres, to assess the different management strategies, and to review neonatal outcomes.
  
  
  METHODS
  Twelve Canadian university-affiliated perinatal referral centres provided information on their management of PPROM, and 9 participated in data collection to determine prevalence. All women presenting with PPROM during a 2-week period were observed until delivery, and obstetric and neonatal outcome data were subsequently obtained. The total number of deliveries in each centre was recorded for the same time period. We also determined the incidence of PPROM and the neonatal outcome for all women presenting with PPROM at the Kingston General Hospital from January 1999 to December 2001 by retrospective chart review.
  
  
  RESULTS
  In the 9 academic centres, 27 women (1 with a twin pregnancy) presented with PPROM during the 2-week period. There were 1168 deliveries during the same time period, giving a prevalence of PPROM of 2.3%. Overall, 53% of placentas submitted for histopathology after PPROM demonstrated evidence of chorioamnionitis. In the retrospective chart review, we found 153 cases of confirmed PPROM from January 1999 to December 2001,an incidence of 2.8%. Clinical management in all centres was similar for most women who presented with PPROM prior to 34 weeks' gestation. Management after 34 weeks' gestation varied among the 12 centres, ranging from immediate induction of labour to expectant management and induction at a greater gestational age (GA).
  
  
  CONCLUSIONS
  The increased neonatal morbidity associated with PPROM appears to be inversely related to GA. Increased risk of chorioamnionitis is related to increased time from PPROM to delivery.
authors.affiliation: Department of Obstetrics and Gynaecology, Queen's University, Kingston, Ontario, Canada.
authors.forename: Graeme
authors.initials: G
authors.lastname: Smith
authors.forename: Christine
authors.initials: C
authors.lastname: Rafuse
authors.forename: Nitasha
authors.initials: N
authors.lastname: Anand
authors.forename: Barb
authors.initials: B
authors.lastname: Brennan
authors.forename: Greg
authors.initials: G
authors.lastname: Connors
authors.forename: Joan
authors.initials: J
authors.lastname: Crane
authors.forename: William
authors.initials: W
authors.lastname: Fraser
authors.forename: Robert
authors.initials: R
authors.lastname: Gratton
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Moutquin
authors.forename: Heather
authors.initials: H
authors.lastname: Scott
authors.forename: Carole
authors.initials: C
authors.lastname: Schneider
authors.forename: Mark
authors.initials: M
authors.lastname: Walker
mesh_terms: D002170:Canada / Q000453:epidemiology; D002821:Chorioamnionitis / Q000150:complications; D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D005865:Gestational Age; D006784:Hospitals, Teaching / Q000706:statistics & numerical data; D006801:Humans; D007231:Infant, Newborn; D008499:Medical Records; D018743:Perinatal Care; D011247:Pregnancy; D011256:Pregnancy Outcome; D015995:Prevalence; D012189:Retrospective Studies