OBJECTIVE: Preterm prelabor rupture of membranes (PPROM) before 27 weeks' gestation is associated with severe perinatal complications, but quantitative estimates are lacking. The aim of this study was to report and predict outcomes of pregnancies complicated by early PPROM and to study antepartum risk factors that might predict perinatal death in future patients. STUDY DESIGN: We performed a retrospective cohort study of women with PPROM between 13(+0) weeks and 27(+0) weeks' gestation between 1994 and 2009 in three perinatal centers. MAIN OUTCOME MEASURES: Perinatal mortality, composite neonatal morbidity and premature delivery. A model to predict these outcomes was developed from antepartum variables. RESULTS: We identified 314 women with PPROM before 27 weeks, including 28 multiple pregnancies. Six pregnancies (2%) were terminated before 24 weeks' gestation, and three were lost to follow up, leaving 305 pregnancies for analysis. Overall, there were 166 perinatal deaths (49%). The perinatal mortality rate decreased with increasing gestational age at PPROM (from 70% in the group PPROM 13-20 weeks to 27% in the group PPROM 24-27 weeks). Of the 170 surviving neonates, 70 suffered from serious morbidity (41%). Early gestational age at PPROM, long interval between PPROM and birth and positive vaginal culture (any bacteria) were associated with perinatal mortality. CONCLUSION: Perinatal mortality in PPROM before 27 weeks occurred in half of the cases and among those who survive approximately 40% suffered serious morbidity. Antenatal parameters can be helpful to predict perinatal mortality. Crown
OBJECTIVE: Preterm prelabor rupture of membranes (PPROM) before 27 weeks' gestation is associated with severe perinatal complications, but quantitative estimates are lacking. The aim of this study was to report and predict outcomes of pregnancies complicated by early PPROM and to study antepartum risk factors that might predict perinatal death in future patients. STUDY DESIGN: We performed a retrospective cohort study of women with PPROM between 13(+0) weeks and 27(+0) weeks' gestation between 1994 and 2009 in three perinatal centers. MAIN OUTCOME MEASURES: Perinatal mortality, composite neonatal morbidity and premature delivery. A model to predict these outcomes was developed from antepartum variables. RESULTS: We identified 314 women with PPROM before 27 weeks, including 28 multiple pregnancies. Six pregnancies (2%) were terminated before 24 weeks' gestation, and three were lost to follow up, leaving 305 pregnancies for analysis. Overall, there were 166 perinatal deaths (49%). The perinatal mortality rate decreased with increasing gestational age at PPROM (from 70% in the group PPROM 13-20 weeks to 27% in the group PPROM 24-27 weeks). Of the 170 surviving neonates, 70 suffered from serious morbidity (41%). Early gestational age at PPROM, long interval between PPROM and birth and positive vaginal culture (any bacteria) were associated with perinatal mortality. CONCLUSION: Perinatal mortality in PPROM before 27 weeks occurred in half of the cases and among those who survive approximately 40% suffered serious morbidity. Antenatal parameters can be helpful to predict perinatal mortality. Crown
Authors: Kathrin Hanke; Annika Hartz; Maike Manz; Meike Bendiks; Friedhelm Heitmann; Thorsten Orlikowsky; Andreas Müller; Dirk Olbertz; Thomas Kühn; Jens Siegel; Axel von der Wense; Christian Wieg; Angela Kribs; Anja Stein; Julia Pagel; Egbert Herting; Wolfgang Göpel; Christoph Härtel Journal: PLoS One Date: 2015-04-09 Impact factor: 3.240
Authors: Augustinus S P van Teeffelen; David P van der Ham; Christine Willekes; Salwan Al Nasiry; Jan G Nijhuis; Sander van Kuijk; Ewoud Schuyt; Twan L M Mulder; Maureen T M Franssen; Dick Oepkes; Fenna A R Jansen; Mallory D Woiski; Mireille N Bekker; Caroline J Bax; Martina M Porath; Monique W M de Laat; Ben W Mol; Eva Pajkrt Journal: BMC Pregnancy Childbirth Date: 2014-04-04 Impact factor: 3.007