Neonatal outcome and two-year follow-up after expectant management of second trimester rupture of membranes.
OBJECTIVE
To assess neonatal outcome and 2-year follow-up of pregnancies complicated by second trimester preterm premature rupture of membranes (PPROM).


METHODS
A retrospective review of obstetric and neonatal records for 87 pregnancies (56 singletons, 6 twins, 1 triplet) with PPROM between 14+0 and 24+6 weeks of gestation. Patients received antibiotics and steroids for fetal lung maturity once they reached 24 weeks of gestation. Placentas were examined histopathologically. Surviving infants were followed-up at 2 years of age.


RESULTS
Median latency from PPROM to delivery was 4 days. Survival rate of 56 singletons was 45% (25/56); and 13 died in hospital. Survival rate of infants discharged from hospital was 23% (12/56). Chorioamnionitis was seen histologically in 42% (5/12) of surviving infants compared with 92% (12/13) of those that died in hospital. Of the 12 surviving infants, 50% had a normal neurological and developmental outcome at 2 years of age.


CONCLUSIONS
Gestational age, birth weight, and histologic chorioamnionitis have prognostic importance in pregnancies complicated by PPROM. Surviving infants have a 50% chance of achieving an adequate health status at 2 years of age.
Pristauz
Gunda
G
Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria. gunda.pristauz@klinikum-graz.at
Bauer
Margit
M
Maurer-Fellbaum
Ute
U
Rotky-Fast
Christa
C
Bader
Arnim A
AA
Haas
Josef
J
Lang
Uwe
U
D000305:Adrenal Cortex Hormones; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002821:Chorioamnionitis / Q000188:drug therapy; D005260:Female; D005313:Fetal Death / Q000209:etiology; D005322:Premature Rupture of Fetal Membranes / Q000175:diagnosis / Q000628:therapy*; D005325:Fetal Organ Maturity / Q000187:drug effects; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000401:mortality*; D008499:Medical Records; D007752:Obstetric Labor, Premature / Q000628:therapy*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011262:Pregnancy Trimester, Second; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors
D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents