Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Nov;124(5):992-998.
doi: 10.1097/AOG.0000000000000511.

Neonatal survival after prolonged preterm premature rupture of membranes before 24 weeks of gestation

Jane E Brumbaugh  1 , Tarah T Colaizy, Nina Nuangchamnong, Emily A O'Brien, Diedre K Fleener, Asha Rijhsinghani, Jonathan M Klein
Affiliations

Neonatal survival after prolonged preterm premature rupture of membranes before 24 weeks of gestation

Jane E Brumbaugh et al. Obstet Gynecol. 2014 Nov.

Abstract

Objective: To evaluate neonatal survival after prolonged preterm premature rupture of membranes (PROM) in the era of antenatal corticosteroids, surfactant, and inhaled nitric oxide.

Methods: A single-center retrospective cohort study of neonates born from 2002-2011 after prolonged (1 week or more) preterm (less than 24 weeks of gestation) rupture of membranes was performed. The primary outcome was survival to discharge. Neonates whose membranes ruptured less than 24 hours before delivery (n=116) were matched (2:1) on gestational age at birth, sex, and antenatal corticosteroid exposure with neonates whose membranes ruptured 1 week or more before delivery (n=58). Analysis used conditional logistic regression for categorical data and Wilcoxon signed rank test for continuous data.

Results: The prolonged preterm PROM exposed and unexposed cohorts had survival rates of 90% and 95%, respectively, although underpowered to assess the statistical significance (P=.313). Exposed neonates were more likely have pulmonary hypoplasia (26/58 exposed, 1/114 unexposed, P<.001), pulmonary hypertension (21/56 exposed, 10/112 unexposed, P<.001), and pulmonary air leak (21/58 exposed, 14/114 unexposed, P<.001). Gestational age at rupture (20.4 weeks exposed, 22.3 weeks unexposed, P=.189), length of rupture (3.7 weeks exposed, 6.4 weeks unexposed, P=.717), and lowest maximal vertical pocket before 24 weeks of gestation (0 cm exposed, 1.4 cm unexposed, P=.114) did not discriminate between survivors and nonsurvivors after exposure to prolonged preterm PROM.

Conclusion: With antenatal steroid exposure and aggressive pulmonary management, survival to discharge after prolonged preterm PROM was 90%. Pulmonary morbidities were common. Of note, the data were limited to women who remained pregnant 1 week or longer after rupture of membranes.

PubMed Disclaimer

References

    1. Martin JA, Hamilton BE, Osterman MJK, Curtin SC, Mathews TJ. Births: final data for 2012. Natl Vital Stat Rep 2013;62:1–87.
    1. Premature rupture of membranes. Practice Bulletin No. 139. American College of Obstetricians and Gynecologists. Obstet Gynecol 2013;122:918–30.
    1. Waters TP, Mercer BM. The management of preterm premature rupture of the membranes near the limit of fetal viability. Am J Obstet Gynecol 2009;201:230–40.
    1. Mercer BM. Management of premature rupture of membranes before 26 weeks' gestation. Obstet Gynecol Clin North Am 1992;19:339–51.
    1. Schucker JL, Mercer BM. Midtrimester premature rupture of the membranes. Semin Perinatol 1996;20:389–400.

Publication types

LinkOut - more resources