Obstetric and Perinatal Outcomes after Very Early Preterm Premature Rupture of Membranes (PPROM)-A Retrospective Analysis over the Period 2000–2020

Abstract

Background and Objectives: Pre-term premature rupture of membranes (PPROM) responds for one third of preterm births, and it is associated with other complications that increase the risk of maternal or fetal poor outcome. To reduce uncertainty and provide accurate information to patients, the analysis of the large series is of great importance. In order to learn about the evolution over the time of the obstetric and perinatal outcomes in cases of PPROM at, or before, 28 weeks (very early PPROM) managed with an expectant/conservative protocol, we have designed the present study. Materials and Methods: We retrospectively studied all cases of very early PPROM attended in Malaga University Regional Hospital from 2000 to 2020. Results: Among 119888 deliveries assisted, 592 cases of PPROM occurred in pregnancies at or before 28 weeks (0.49% of all deliveries, 3.9% of all preterm births and 12.9% of all cases of PPROM). The mean duration of the latency period between PPROM and delivery was 13.5 days (range 0 to 88 days), enlarging over the years. The mean gestational age at delivery was 27 weeks (SD 2.9; range 17–34). The proportion of cesarean deliveries was 52.5%. The overall perinatal mortality rate was 26.5%, decreasing over the period with a significant correlation Pearson’s coefficient −0.128 (p < 0.05). Conclusions: In the period 2000–2020, there was an improvement in the outcomes of very early PPROM cases and perinatal mortality showed a clear trend to decrease.

The Association of Prepregnancy Body Mass Index with Pregnancy Outcomes in Chinese Women

“…Given that gestational diabetes poses an additive impact on the risk of adverse pregnancy or delivery outcomes, we included gestational diabetes as a covariate [ 31 ]. We also, respectively, adjusted the other confounders (including PPROM, anemia, and preeclampsia) to eliminate the potential bias when addressing the pregnancy outcomes [ 27 – 29 ]. The results were consistent with the previous analysis.…”

“…Moreover, we included gestational diabetes as a covariate due to the fact that gestational diabetes possesses an additive impact on the risk of adverse pregnancy or delivery outcomes [ 26 ]. Also, other confounders (including PPROM, anemia, and preeclampsia) were, respectively, adjusted to eliminate the potential bias when addressing the pregnancy outcomes [ 27 – 29 ].…”

The Management of Pregnancy Complicated with the Previable Preterm and Preterm Premature Rupture of the Membranes: What about a Limit of Neonatal Viability?—A Review

“…The study showed that pregnancy duration after PROM was around 14 days, and latency increased over the years. With 53% of caesarean deliveries, the mortality rate was around 26.5% and decreased over the analyzed period ( p < 0.05) [ 26 ].…”

The role of extreme heat exposure on premature rupture of membranes in Southern California: A study from a large pregnancy cohort

“…PPROM is linked to 30–50% of preterm births, as about 50–60% of women with PPROM remote from the term will deliver within one week even with conservative management ( Lyons and McLaughlin, 2020 ; Mercer, 2003 ). PROM can significantly increase morbidity and mortality of both mothers and infants ( Gonzalez-Mesa et al, 2021 ; Henderson et al, 2012 ; Mercer, 2003 ; Newman et al, 2009 ; Stan et al, 2013 ) and result in long-term neurodevelopment and mental health problems of infants ( Clark and Varner, 2011 ; Patkai et al, 2013 ).…”