title: Premature rupture of membranes before 28 weeks managed expectantly: maternal and perinatal outcomes in a developing country.
abstract: This study aimed to assess outcomes of expectant management for early preterm premature rupture of membranes (PPROM). This retrospective cohort involved 66 women with PPROM <28 weeks managed in a single hospital (1999-2006). Main outcomes were chorioamnionitis, severe maternal morbidity (maternal sepsis, haemorrhage/blood transfusion, hysterectomy or admission to intensive care unit), maternal mortality, low birth weight, preterm birth, neonatal infection and perinatal mortality. Mean gestational ages at PPROM and delivery were 21.7 ± 4.2 and 28.4 ± 5.9 weeks, respectively. Chorioamnionitis was diagnosed in 47%; no cases of severe maternal morbidity or mortality occurred. Stillbirth rate was 25.7% and >80% of infants were delivered before 34 weeks. Neonatal infection was diagnosed in 42.9% of the 49 live-births. Overall survival rate was 57.6%. Expectant management of PPROM <28 weeks resulted in high rates of chorioamnionitis and preterm deliveries but in over half of the cases, a live infant was discharged home.
authors.affiliation: High Risk Pregnancy Unit, Hospital Municipal Universitário, Faculdade de Medicina do ABC, São Bernardo do Campo, Brazil.
authors.forename: G L
authors.initials: GL
authors.lastname: Fernandes
authors.forename: M R
authors.initials: MR
authors.lastname: Torloni
authors.forename: W Jou
authors.initials: WJ
authors.lastname: Hisaba
authors.forename: D
authors.initials: D
authors.lastname: Klimke
authors.forename: J
authors.initials: J
authors.lastname: Novaes
authors.forename: M
authors.initials: M
authors.lastname: Sancovski
authors.forename: S
authors.initials: S
authors.lastname: Peixoto
mesh_terms: D000328:Adult; D001938:Brazil / Q000453:epidemiology; D003906:Developing Countries; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000453:epidemiology*; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies