title: Predictive factors for neonatal survival in women with periviable preterm rupture of the membranes.
abstract: OBJECTIVE
  To identify clinical, hematological or instrumental factors available at the time of the diagnosis that may predict neonatal survival in periviable preterm premature rupture of the membranes (PROM).
  
  
  METHODS
  We report on a cohort (n = 85) of women with periviable PROM (14-23.6 weeks' gestation) occurring over a 10-year period in a single institution. The main outcome chosen was the survival rate beyond the neonatal period. Variables considered were those available at 24 h after admission.
  
  
  RESULTS
  The overall survival rate was 49%. In the multivariate analysis, significant contributions for the prediction of neonatal survival were provided by four variables: genetic amniocentesis-related cause of PROM (p < 0.001), gestational age at PROM (p = 0.019), CRP > 1 mg/dl within 24 h after admission (p = 0.042) and oligohydramnios (largest vertical pocket ≤2 cm) (p = 0.041). The corresponding adjusted odds ratio (OR)s were 73.9 (95% CI: 7.9-694.7), 1.5 (95% CI: 1.1-2.0) per week, 0.26 (95% CI: 0.07-0.95) and 0.20 (95% CI: 0.04-0.93), respectively.
  
  
  CONCLUSIONS
  Genetic amniocentesis-related cause of PROM, gestational age at PROM, C-reactive protein >1 mg/dl and oligohydramnios are significantly associated with survival in women with periviable PROM. The evaluation of these few and easily available variables may help physicians and patients in the decision-making process of this demanding condition.
authors.affiliation: Department of Obstetrics and Gynecology , Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico .
authors.forename: Barbara
authors.initials: B
authors.lastname: Acaia
authors.forename: Francesca
authors.initials: F
authors.lastname: Crovetto
authors.forename: Manuela W
authors.initials: MW
authors.lastname: Ossola
authors.forename: Silvia
authors.initials: S
authors.lastname: Nozza
authors.forename: Giulia Maria
authors.initials: GM
authors.lastname: Baffero
authors.forename: Edgardo
authors.initials: E
authors.lastname: Somigliana
authors.forename: Carlo
authors.initials: C
authors.lastname: Pietrasanta
authors.forename: Lorenza
authors.initials: L
authors.lastname: Pugni
authors.forename: Fabio
authors.initials: F
authors.lastname: Mosca
authors.forename: Luigi
authors.initials: L
authors.lastname: Fedele
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000175:diagnosis* / Q000401:mortality*; D005865:Gestational Age; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000175:diagnosis / Q000401:mortality; D011247:Pregnancy; D047928:Premature Birth / Q000175:diagnosis* / Q000401:mortality*; D011379:Prognosis; D013534:Survival; D015996:Survival Rate