Journal List > Perinatology > v.30(4) > 1144128

Perinatology. 2019 Dec;30(4):193-199. Korean.
Published online Dec 31, 2019.  https://doi.org/10.14734/PN.2019.30.4.193
Copyright © 2019 The Korean Society of Perinatology
Perinatal Outcomes Following Prolonged Preterm Premature Rupture of Membranes before Limit of Viability - A Single Center Experience
Na Hyun Lee, MD,1 Jae Hyun Park, MD, PhD,1 and Jin Gon Bae, MD2
1Department of Pediatrics, Keimyung University Dongsan Medical Center, Daegu, Korea.
2Department of Obstetrics and Gynecology, Keimyung University Dongsan Medical Center, Daegu, Korea.

Correspondence to Jae Hyun Park, MD, PhD. Department of Pediatrics, Keimyung University Dongsan Medical Center, 1035 Dalgubeol-daero, Dalseo-gu, Daegu 42601, Korea. Tel: +82-53-258-4852, Fax: +82-53-258-4875, Email: jhpark.neo@gmail.com
Received May 12, 2019; Revised May 20, 2019; Accepted Jun 11, 2019.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Abstract

Objective

To investigate maternal and neonatal outcomes following prolonged preterm premature rupture of membrane (PPROM) before limit of viability in a single center.

Methods

Thirty-two women with PPROM before 25 weeks' gestation without overt intrauterine infection were administered expectant management. We investigated maternal and neonatal outcomes of pregnancies following PPROM occurring before 25 weeks' gestation and with latent period (from membrane rupture to delivery) of 7 days or more.

Results

Median gestational age at membrane rupture was 22.1 weeks. Median latent period was 32 days. Median gestational age at delivery was 26.6 weeks. The incidence of clinical pulmonary hypoplasia and early onset sepsis was 43.5% (10/23) and 21.7% (5/23), respectively. The overall mortality in neonatal intensive care unit (NICU) was 43.5% (10/23). Latent period was negatively correlated with gestational age at membrane rupture (r=−0.501, P=0.015), but not associated with maternal complications. As the length of latent period increased, overall mortality in NICU decreased (relative risk=0.898, P=0.011).

Conclusion

The expectant management in women with PPROM before 25 weeks' gestation did not induce maternal complications and might help to improve the neonatal outcomes rather than the immediate delivery.

Keywords: Fetal membranes, premature rupture; Pregnancy maintenance; Pregnancy complications; Infant mortality

Figures


Fig. 1
Flowchart of pregnant women and infants with PPROM before 25 weeks of gestation. PPROM, prolonged preterm premature rupture of membrane; GA, gestaional age; NICU, neonatal intensive care unit.
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Tables


Table 3
Infants Who Died in Neonatal Intensive Care Unit
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Table 4
Infants Who Survived in Neonatal Intensive Care Unit
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Table 5
Correlation Coefficient between Perinatal Parameters and Latent Period
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Table 6
Maternal and Neonatal Outcomes Associated with Latent Period from Membrane Rupture to Delivery
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