Maternal and neonatal outcomes following expectant management of preterm prelabour rupture of membranes before viability
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.
References
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The authors stated that there are no conflicts of interest regarding the publication of this article.
©2017 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Frontmatter
- Editorial
- What’s new in preterm birth prediction and prevention?
- Academy’s Corner
- Antenatal corticosteroids: current controversies
- Review articles
- The safety of progestogen in the prevention of preterm birth: meta-analysis of neonatal mortality
- Cervical pessary for the prevention of preterm birth: is it of any use?
- Maternal and neonatal outcomes following expectant management of preterm prelabour rupture of membranes before viability
- Highlight articles
- Placental malperfusion as a possible mechanism of preterm birth in patients with Müllerian anomalies
- Nifedipine increases fetoplacental perfusion
- Effect of sleep disorders on threatened premature delivery
- Risk of recurrent preterm birth among women according to change in partner
- Biomarkers of spontaneous preterm birth: a systematic review of studies using multiplex analysis
- Influence of transvaginal ultrasound examination on quantitative vaginal fibronectin measurements: a prospective evaluation study
- Evaluation of quantitative fFn test in predicting the risk of preterm birth
- The value of ultrasound measurement of cervical length and parity in prediction of cesarean section risk in term premature rupture of membranes and unfavorable cervix
- Comparison of the duo of insulin-like growth factor binding protein-1/alpha fetoprotein (Amnioquick duo+®) and traditional clinical assessment for diagnosing premature rupture of fetal membranes
- Efficacy of a prospective community-based intervention to prevent preterm birth
- Maternal complications in settings where two-thirds of extremely preterm births are delivered by cesarean section
- The risk of neonatal respiratory morbidity according to the etiology of late preterm delivery
- Thyroid dysfunction in preterm neonates exposed to iodine
- Congress Calendar
- Congress Calendar
Articles in the same Issue
- Frontmatter
- Editorial
- What’s new in preterm birth prediction and prevention?
- Academy’s Corner
- Antenatal corticosteroids: current controversies
- Review articles
- The safety of progestogen in the prevention of preterm birth: meta-analysis of neonatal mortality
- Cervical pessary for the prevention of preterm birth: is it of any use?
- Maternal and neonatal outcomes following expectant management of preterm prelabour rupture of membranes before viability
- Highlight articles
- Placental malperfusion as a possible mechanism of preterm birth in patients with Müllerian anomalies
- Nifedipine increases fetoplacental perfusion
- Effect of sleep disorders on threatened premature delivery
- Risk of recurrent preterm birth among women according to change in partner
- Biomarkers of spontaneous preterm birth: a systematic review of studies using multiplex analysis
- Influence of transvaginal ultrasound examination on quantitative vaginal fibronectin measurements: a prospective evaluation study
- Evaluation of quantitative fFn test in predicting the risk of preterm birth
- The value of ultrasound measurement of cervical length and parity in prediction of cesarean section risk in term premature rupture of membranes and unfavorable cervix
- Comparison of the duo of insulin-like growth factor binding protein-1/alpha fetoprotein (Amnioquick duo+®) and traditional clinical assessment for diagnosing premature rupture of fetal membranes
- Efficacy of a prospective community-based intervention to prevent preterm birth
- Maternal complications in settings where two-thirds of extremely preterm births are delivered by cesarean section
- The risk of neonatal respiratory morbidity according to the etiology of late preterm delivery
- Thyroid dysfunction in preterm neonates exposed to iodine
- Congress Calendar
- Congress Calendar