title: Maternal and Neonatal Outcomes of Preterm Premature Rupture of Membranes before Viability.
abstract: BACKGROUND
  To investigate maternal and neonatal outcomes of previable preterm premature rupture of membranes (PPROM) and compare outcome between previable PPROM before and after 20 weeks of pregnancy, with data from one single center.
  
  
  METHODS
  All women with singleton or twin pregnancies, from 2002 through 2011, who presented with PPROM before 24 weeks of gestation.
  
  
  METHODS
  A retrospective cohort study in a university teaching hospital in the Netherlands. Data were analyzed and compared between pregnancies with previable PPROM before and after 20 weeks of pregnancy. Main outcome measures were maternal and neonatal morbidity and mortality.
  
  
  RESULTS
  A total of 160 women (164 fetuses) were included. 90 women (56.2%) developed complications (intra-uterine infection, retained placenta, placental abruption or sepsis). There was no maternal mortality. 68 neonates were admitted after birth. PPHN (64.7%, p=0.001) and contractures (58.8%, p<0.001) occurred significantly more in neonates born after PPROM<20 weeks of pregnancy. Eventually 38.4% of the neonates survived. Neonates born after previable PPROM > 20 weeks had a greater likelihood of being alive at discharge (22.7 vs. 46.9%, p=0.008).
  
  
  CONCLUSIONS
  This study of previable PPROM shows that more than 50% of the mothers develop one or more complications. Neonates have a high mortality rate, especially neonates born after PPROM<20 weeks of pregnancy. In particular neonates born after PPROM<20 weeks of pregnancy should be watched closely for PPHN and contractures.
  
  
  CONCLUSIONS
  This large single center study can provide good foundation for counseling parents on previable PPROM, especially the prognosis of PPROM<20 weeks of pregnancy is of additional value.
authors.affiliation: Erasmus MC, Department of Obstetrics and Gynecology, Division of Obstetrics and Prenatal Medicine Rotterdam, Netherlands.
authors.forename: I
authors.initials: I
authors.lastname: van der Marel
authors.affiliation: Erasmus MC, Department of Pediatrics, Division of Neonatology, Rotterdam, Netherlands.
authors.forename: R
authors.initials: R
authors.lastname: de Jonge
authors.affiliation: Erasmus MC, Department of Obstetrics and Gynecology, Division of Obstetrics and Prenatal Medicine Rotterdam, Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: Duvekot
authors.affiliation: Erasmus MC, Department of Pediatrics, Division of Neonatology, Rotterdam, Netherlands.
authors.forename: I
authors.initials: I
authors.lastname: Reiss
authors.affiliation: Erasmus MC, Department of Obstetrics and Gynecology, Division of Obstetrics and Prenatal Medicine Rotterdam, Netherlands.
authors.forename: I
authors.initials: I
authors.lastname: Brussé
mesh_terms: D002423:Cause of Death; D015331:Cohort Studies; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000401:mortality*; D005328:Fetal Viability; D005865:Gestational Age; D006784:Hospitals, Teaching; D006801:Humans; D007231:Infant, Newborn; D000071074:Neonatal Sepsis / Q000401:mortality; D009426:Netherlands; D016104:Oligohydramnios / Q000401:mortality; D011247:Pregnancy; D011256:Pregnancy Outcome; D011272:Pregnancy, Multiple; D012189:Retrospective Studies; D012307:Risk Factors; D013290:Streptococcal Infections / Q000401:mortality; D013292:Streptococcus agalactiae