Amniocentesis in the management of preterm premature rupture of the membranes: a retrospective cohort analysis.
OBJECTIVE
This retrospective analysis determined the utility of amniocentesis in the management of preterm premature rupture of the membranes (PPROM).


METHODS
Consecutive patients with PPROM were managed with and without amniocentesis. Both groups received antibiotics and corticosteroids; tocolytics were withheld. Patients were induced if clinical or amniotic fluid (AF) proven chorioamnionitis occurred or gestational age goals were reached. Primary endpoints were individual and composite neonatal morbidity (CNM).


RESULTS
One hundred forty-seven maternal patients were managed with amniocentesis (AC) and 146 were managed without amniocentesis (NAC). CNM was significantly reduced in the group managed with AC (OR 2.94, 95% CI 1.68-5.15, NAC vs. AC). NAC patients had similar rates of neonatal sepsis as well as CNM to those patients in the AC group with positive AF Gram stains and/or cultures.


CONCLUSIONS
Patients with PPROM who are managed with AC have significantly less CNM than NAC patients.
Porreco
Richard P
RP
Presbyterian/St Luke's Medical Center, Obstetrix Medical Group of Colorado, Denver, Colorado 80218, USA. Richard_porreco@obstetrix.com
Heyborne
Kent D
KD
Shapiro
Howard
H
D000328:Adult; D000649:Amniocentesis / Q000379:methods; D001724:Birth Weight; D002097:C-Reactive Protein / Q000032:analysis; D015331:Cohort Studies; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000097:blood / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D007231:Infant, Newborn; D007958:Leukocyte Count; D054238:Perinatal Mortality; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D018805:Sepsis / Q000453:epidemiology / Q000401:mortality
D002097:C-Reactive Protein