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Maternal and neonatal outcomes following expectant management of preterm prelabour rupture of membranes before viability.
- Source :
-
Journal of Perinatal Medicine . Jan2017, Vol. 45 Issue 1, p29-44. 16p. 8 Charts. - Publication Year :
- 2017
-
Abstract
- Aim: To assess the contemporary maternal and neonatal outcomes following expectant management of preterm premature rupture of membranes (PPROM) prior to 24 weeks' gestation and to identify prognostic indicators of this morbid presentation. Methods: We performed a systematic review in the Pubmed and EMBASE databases to identify the primary (perinatal mortality, severe neonatal morbidity and serious maternal morbidity) and secondary (neonatal survival and morbidity) outcomes following expectant management of previable PPROM. Results: Mean latency between PPROM and delivery ranged between 20 and 43 days. Women with PPROM < 24 weeks had an overall live birth rate of 63.6% and a survival-to-discharge rate of 44.9%. The common neonatal morbidities were respiratory distress syndrome, bronchopulmonary dysplasia and sepsis. The majority of neonatal deaths within 24 h post birth were associated with pulmonary hypoplasia, severe intraventricular haemorrhage and neonatal sepsis. The common maternal outcomes were chorioamnionitis and caesarean sections. The major predictors of neonatal survival were later gestational age at PPROM, adequate residual amniotic fluid levels, C-reactive protein < 1 mg/dL within 24 h of admission and PPROM after invasive procedures. Conclusion: Pregnancy latency and neonatal survival following previable PPROM has improved in recent years, although neonatal morbidity remains unchanged despite recent advances in obstetric and neonatal care. There is heterogeneity in management practices across centres worldwide. [ABSTRACT FROM AUTHOR]
- Subjects :
- *AMNIOTIC liquid
*C-reactive protein
*CESAREAN section
*BIRTH rate
*DELIVERY (Obstetrics)
*FETAL diseases
*GESTATIONAL age
*PREMATURE infants
*PREMATURE infant diseases
*INFANT mortality
*MEDICAL information storage & retrieval systems
*MATERNAL health services
*EVALUATION of medical care
*MEDLINE
*ONLINE information services
*PREGNANCY
*PREGNANCY complications
*PREGNANT women
*SURVIVAL analysis (Biometry)
*SYSTEMATIC reviews
*DESCRIPTIVE statistics
*NEONATAL sepsis
*DISEASE complications
Subjects
Details
- Language :
- English
- ISSN :
- 03005577
- Volume :
- 45
- Issue :
- 1
- Database :
- Academic Search Index
- Journal :
- Journal of Perinatal Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 120714259
- Full Text :
- https://doi.org/10.1515/jpm-2016-0183