Neonatal morbidity and mortality secondary to premature rupture of membranes

Abstract

PROM is one of the most common complications of pregnancy that has a major impact on neonatal mortality and morbidity. The occurrence of PROM is either directly or indirectly responsible for a large number of premature births and the concomitant mortality and morbidity associated with preterm delivery. PROM turns a pregnancy into a high-risk situation and increases the need for neonatal resuscitation in the delivery room. The incidence of neonatal sepsis increases with PROM, but the overall outcome of the neonate, even with surfactant therapy, is still primarily dependent on the gestational age at the time of delivery. This is most relevant between 24 and 27 weeks' gestation. During this 3-week interval, survival improves by almost 2% for each additional day of in utero maturation (i.e., from 35 to 75%). Thus the benefit to the fetus of prolonging the pregnancy in cases of PROM is immensely worthwhile and should be aggressively pursued as long as there is no significant increase in maternal morbidity.