A systematic review of pregnancy outcome following preterm premature rupture of membranes at a previable gestational age.

Our objective was to identify the maternal and fetal outcome following preterm premature rupture of membranes at a previable gestational age (less than 23 weeks). We conducted a systematic review to identify articles that assessed perinatal and maternal outcome of pregnancies complicated by preterm premature rupture of membranes in early weeks of gestation. Articles available in the electronic database (MEDLINE and EMBASE) from the year 1980 to 1999 were included in the review The subjects were patients with rupture of membranes less than 23 weeks of gestation. Two reviewers independently reviewed the abstracts and finally 11 articles were eligible. Data were extracted separately from available sources within the articles. Data on individual subjects were extracted in eight studies whereas in three studies it was only possible to extract the data on divided gestational age groups. We found a live birth rate of 67% (95% CI: 60-73) in these groups of patients. The perinatal survival was 18% (95 % CI: 11-28) and 17% (95% CI: 16-27) in less than 20 weeks and 20-23 weeks groups respectively. Very little information could be extracted regarding perinatal morbidity Respiratory distress syndrome was diagnosed to be the major morbidity among the surviving infants. The review illustrates how little good quality information is available for pregnancy outcome following PPROM at less than 23 weeks gestation. Although the survival prognosis of this group of patients is poor, the perinatal survival is approximately 21%.