Maternal and Neonatal Outcomes of Preterm Premature Rupture of Membranes before Viability

BACKGROUND To investigate maternal and neonatal outcomes of previable preterm premature rupture of membranes (PPROM) and compare outcome between previable PPROM before and after 20 weeks of pregnancy, with data from one single center. PATIENTS All women with singleton or twin pregnancies, from 2002 through 2011, who presented with PPROM before 24 weeks of gestation. METHOD A retrospective cohort study in a university teaching hospital in the Netherlands. Data were analyzed and compared between pregnancies with previable PPROM before and after 20 weeks of pregnancy. Main outcome measures were maternal and neonatal morbidity and mortality. RESULTS A total of 160 women (164 fetuses) were included. 90 women (56.2%) developed complications (intra-uterine infection, retained placenta, placental abruption or sepsis). There was no maternal mortality. 68 neonates were admitted after birth. PPHN (64.7%, p=0.001) and contractures (58.8%, p 20 weeks had a greater likelihood of being alive at discharge (22.7 vs. 46.9%, p=0.008). DISCUSSION This study of previable PPROM shows that more than 50% of the mothers develop one or more complications. Neonates have a high mortality rate, especially neonates born after PPROM