title: Subsequent Pregnancy after Preterm Prelabor Rupture of Membranes before 27 Weeks' Gestation.
abstract: Objective Midtrimester preterm prelabor rupture of membranes (PPROM) has a high rate of neonatal mortality and morbidity. The aim of this study was to study outcomes of subsequent pregnancies after a pregnancy with PPROM before 27 weeks' gestation. Study Design Retrospective study of subsequent pregnancies of women who suffered PPROM before 27 weeks' gestation from 1994 to 2009. The main outcome measure was the risk of recurrence of PPROM before 27 weeks' gestation. The authors also studied preterm birth and pregnancy outcome in the subsequent pregnancy. Finally, they assessed associative factors for subsequent premature delivery. Results They identified 307 patients, of whom 118 women had a subsequent pregnancy. Of 99 women with complete outcome data, 9 women (9%) had PPROM before 27 weeks' gestation in a subsequent pregnancy and 35 women (35%) had a preterm delivery. In 58 (59%) of pregnancies no major complications occurred. They found three associative factors for premature delivery in a subsequent pregnancy: negative vaginal culture for Group B streptococcus, increasing maternal age and early gestational age at PPROM in the index pregnancy. Conclusions Women with PPROM before 27 weeks have a 9% recurrence risk of early PPROM and a risk of 35% of having a preterm delivery in a subsequent pregnancy.
authors.affiliation: Department of Obstetrics and Gynecology, Maastricht University Medical Center, GROW School for Oncology and Developmental Biology, The Netherlands.
authors.forename: Jantien L
authors.initials: JL
authors.lastname: van der Heyden
authors.forename: Sander M J
authors.initials: SM
authors.lastname: van Kuijk
authors.forename: David P
authors.initials: DP
authors.lastname: van der Ham
authors.forename: Kim J B
authors.initials: KJ
authors.lastname: Notten
authors.forename: Timothy
authors.initials: T
authors.lastname: Janssen
authors.forename: Jan G
authors.initials: JG
authors.lastname: Nijhuis
authors.forename: Christine
authors.initials: C
authors.lastname: Willekes
authors.forename: Martina
authors.initials: M
authors.lastname: Porath
authors.forename: Joris A
authors.initials: JA
authors.lastname: van der Post
authors.forename: Feico
authors.initials: F
authors.lastname: Halbertsma
authors.forename: Eva
authors.initials: E
authors.lastname: Pajkrt
authors.forename: Ben Willem J
authors.initials: BW
authors.lastname: Mol
keywords: preterm birth; preterm rupture of membranes; recurrence