Outcome of pregnancies with spontaneous PPROM before 24+0 weeks' gestation.
OBJECTIVE
To examine the contemporary outcome in women with rupture of membranes (PPROM) before 24+0 weeks' gestation.


METHODS
Retrospective analysis of women with spontaneous PPROM before 24+0 weeks that were treated at the University of Tuebingen/Germany. The search of the database included common maternal and pregnancy characteristics as well as the neonatal outcomes.


RESULTS
One hundred and one pregnancies fulfilled the inclusion criteria. 32 (31.7%) women opted for termination of pregnancy, which were excluded from further analysis. The gestational age at PPROM in the 69 women with an expectant management was 21.3 (IQR 19.1-22.6) weeks. 40 (58.0%) pregnancies carried on beyond 24+0 weeks. Multiple regression analysis indicated that the time of PPROM and the absence of oligo-/anhydramnios were associated with a prolongation beyond 24+0 weeks. In the 40 pregnancies that remained intact beyond 24+0 weeks' gestation, the fetuses were born at 27.7 (IQR 25.3-30.9) weeks. Survival without major complications was observed in 22 (55.0%) fetuses. Multiple regression analysis indicated that only the gestational age at the time of delivery was significantly associated with such an intact survival.


CONCLUSIONS
In cases with PPROM there is a 60% chance of a prolongation beyond 24+0 weeks. About half of these fetuses will be discharged alive without major complications.
Department of Obstetrics and Gynaecology, University of Tuebingen, Germany.
Philipp
P
Wagner
Fetal Medicine Foundation USA, Dayton, OH, USA; Division of Maternal Fetal Medicine, Wright State University, Dayton, OH, USA.
Jiri
J
Sonek
Department of Obstetrics and Gynaecology, University of Tuebingen, Germany.
Stefanie
S
Mayr
Department of Obstetrics and Gynaecology, University of Tuebingen, Germany.
Harald
H
Abele
Department of Neonatology, University of Tuebingen, Germany.
Rangmar
R
Goelz
Department of Obstetrics and Gynaecology, University of Tuebingen, Germany.
Markus
M
Hoopmann
Department of Obstetrics and Gynaecology, University of Tuebingen, Germany. Electronic address: KOKagan@gmx.de.
Karl Oliver
KO
Kagan
D000028:Abortion, Induced; D000328:Adult; D015331:Cohort Studies; D005260:Female; D005313:Fetal Death / Q000209:etiology / Q000517:prevention & control; D005322:Premature Rupture of Fetal Membranes / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D005328:Fetal Viability; D005858:Germany / Q000453:epidemiology; D005865:Gestational Age; D006785:Hospitals, University; D006801:Humans; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D016104:Oligohydramnios / Q000209:etiology; D057240:Patient Preference; D066087:Perinatal Death / Q000209:etiology / Q000517:prevention & control; D011247:Pregnancy; D011255:Pregnancy Maintenance; D012189:Retrospective Studies; D012306:Risk; D057832:Watchful Waiting
Neonatal; Outcome; PPROM; Prenatal; Viability