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Outcome of pregnancies with preterm prelabor rupture of membranes before 27 weeks' gestation: a retrospective cohort study
- Source :
- European journal of obstetrics, gynecology, and reproductive biology, 170(1), 125-130. Elsevier Ireland Ltd, European Journal of Obstetrics & Gynecology and Reproductive Biology, 170(1), 125-130. Elsevier
- Publication Year :
- 2013
-
Abstract
- Objective Preterm prelabor rupture of membranes (PPROM) before 27 weeks’ gestation is associated with severe perinatal complications, but quantitative estimates are lacking. The aim of this study was to report and predict outcomes of pregnancies complicated by early PPROM and to study antepartum risk factors that might predict perinatal death in future patients. Study design We performed a retrospective cohort study of women with PPROM between 13 +0 weeks and 27 +0 weeks’ gestation between 1994 and 2009 in three perinatal centers. Main outcome measures Perinatal mortality, composite neonatal morbidity and premature delivery. A model to predict these outcomes was developed from antepartum variables. Results We identified 314 women with PPROM before 27 weeks, including 28 multiple pregnancies. Six pregnancies (2%) were terminated before 24 weeks’ gestation, and three were lost to follow up, leaving 305 pregnancies for analysis. Overall, there were 166 perinatal deaths (49%). The perinatal mortality rate decreased with increasing gestational age at PPROM (from 70% in the group PPROM 13–20 weeks to 27% in the group PPROM 24–27 weeks). Of the 170 surviving neonates, 70 suffered from serious morbidity (41%). Early gestational age at PPROM, long interval between PPROM and birth and positive vaginal culture (any bacteria) were associated with perinatal mortality. Conclusion Perinatal mortality in PPROM before 27 weeks occurred in half of the cases and among those who survive approximately 40% suffered serious morbidity. Antenatal parameters can be helpful to predict perinatal mortality.
- Subjects :
- Adult
Pediatrics
medicine.medical_specialty
Fetal Membranes, Premature Rupture
Neonatal morbidity
Infant, Premature, Diseases
Midtrimester PPROM
Pregnancy
Medicine
Rupture of membranes
Humans
Lost to follow-up
Netherlands
Retrospective Studies
Perinatal mortality
business.industry
Obstetrics
Infant, Newborn
Pregnancy Outcome
Obstetrics and Gynecology
Gestational age
Retrospective cohort study
Preterm birth
Preterm rupture of membranes
Reproductive Medicine
Gestation
Female
business
Infant, Premature
Perinatal Deaths
Subjects
Details
- Language :
- English
- ISSN :
- 03012115
- Volume :
- 170
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- European Journal of Obstetrics & Gynecology and Reproductive Biology
- Accession number :
- edsair.doi.dedup.....7619f003db2aa82bce964b3f62910acc