title: Optimum mode of delivery in gestations complicated by preterm premature rupture of the membranes.
abstract: OBJECTIVE
  To provide evidence about the preferable mode of delivery, vaginal (VD) or caesarean section (CS), in PPROM.
  
  
  METHODS
  A retrospective study of 190 cases. Survival analysis was used to identify statistically significant differences in mortality rates.
  
  
  RESULTS
  A total of 126 pregnancies were included in our study. Mean gestational age of rupture was 28(+0) weeks (min = 15, max = 36(+4), sd = 5.796). Mean birth age was 30(+0) weeks (min = 15, max = 37(+2), sd = 5.353). CS was performed in 55 cases (43.7%), VD in 71 cases (56.3%). Data analysis showed that, regardless of presentation, there was a statistically significant benefit on survival in favor of the CS in births below 30 gestational weeks (n = 39, nCS = 18, nND = 21, χ(2) = 7.946, p = 0.005). Hazard ratio estimation set the critical gestational age at 28 weeks. For vaginal deliveries, breech presentation was associated with inferior survival outcome compared to vertex (nTotal = 71; nVertex = 63, nBreech = 8, χ(2) = 13.012, p < 0.001.Also in breech presentation, VD survival outcome was inferior to CS (nTotal = 9; nVD = 6, nCS = 3, χ(2) = 5.145, p < 0.05).
  
  
  CONCLUSIONS
  According to our results, in cases of PPROM, CS was beneficial below 28 weeks and in breech presentation below 30 weeks.
authors.affiliation: 1st Obstetrics and Gynecology Clinic, University Hospital Alexandra, Athens, Greece. thanasism@yahoo.com
authors.forename: Athanasios
authors.initials: A
authors.lastname: Mousiolis
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Papantoniou
authors.forename: Spyros
authors.initials: S
authors.lastname: Mesogitis
authors.forename: Labrini
authors.initials: L
authors.lastname: Baglatzi
authors.forename: Giorgos
authors.initials: G
authors.lastname: Baroutis
authors.forename: Aris
authors.initials: A
authors.lastname: Antsaklis
mesh_terms: D001946:Breech Presentation / Q000401:mortality; D002585:Cesarean Section / Q000401:mortality*; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000401:mortality*; D006115:Greece / Q000453:epidemiology; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D011247:Pregnancy; D047928:Premature Birth / Q000401:mortality*; D012189:Retrospective Studies