Survival and 2-year outcome with expectant management of second-trimester rupture of membranes

Abstract

Expectant management of second-trimester PROM offers better perinatal and long-term survival than previously thought.

Amnioinfusion in preterm premature rupture of membranes (AMIPROM): a randomised controlled trial of amnioinfusion versus expectant management in very early preterm premature rupture of membranes – a pilot study

“…[3][4][5][6][7][8][9][10][11] The major risk of expectant is maternal infection leading to sepsis. High rates of postpartum morbidity 10 and chorioamnionitis 11 have been reported: 32% and 28%, respectively. The Royal College of Obstetricians and Gynaecologists (RCOG) guideline on PPROM 12 does not give any specific guidance on the management of these pregnancies.…”

“…The median number of antenatal visits prior to delivery was 5 (range 0-15) in the AI arm and 4.5 (range [1][2][3][4][5][6][7][8][9][10][11][12][13][14] in the Exp arm ( Table 5). The median number of AI performed was 3 (range 0-12; Table 6).…”

Preterm Prelabor Rupture of Membranes and Severe Oligohydramnios from 22-34 Weeks of Amenorrhea

“…According to other studies on preterm PROM, clinically evident intra-amniotic infection occurs in 13-60%, and postpartum infection occurs in 2-13% [6]. The incidence of infection increases with decreasing gestational age at membrane rupture [7].…”

“…She was later discharged at 23. 6 Weeks of amenorrhea on erythromycin 500mg every 6hrs for 5 days and was scheduled to attend the High risk antenatal clinic. She was counselled on the danger signs and what to lookout for.…”

Outcome of Twin Pregnancies Complicated By Early Second Trimester Rupture of Membranes in One Sac

“…Cases in which spontaneous delivery does not occur and the parents want to continue the pregnancy are rare and present a dilemma. Previous publications suggest that second trimester ROM may be associated with severe perinatal and neonatal morbidity such as fetal demise, premature labor and complications related to prematurity, hypoplastic lungs, limb contractures, and significant maternal morbidity due to infection (Everest et al, 2008;Farooqi et al, 1998;Grisaru-Granovsky et al, 2003;Hibbard et al, 1993;Lindner et al, 2002;Pristauz et al, 2008;Shumway et al, 1999;Vergani et al, 1994;Verma et al, 2006;Yang et al, 2004). In Israel, termination of the entire pregnancy is the common practice in these circumstances.…”