Maternal and neonatal outcomes in preterm prelabour rupture of membranes between 24 and 34 weeks gestation. (7th June 2011) - Sephton, V
Abstract : The mainstay of management of women with preterm prelabour rupture of membranes (PPROM) in the UK is expectant management. Aim: To determine the maternal and neonatal outcome in women with a possible diagnosis of PPROM at 24–34 weeks, attending our unit between April 2007 and July 2010. Methods: Retrospective case note review, computerised patient records identified eligible cases. Results: 30 cases (50% of the cohort) have been analysed so far. Mean gestation for PPROM was 217.27 days (31 weeks+0 days). Mean gestation for delivery was 225.77 days. (32 weeks+2 days). Mean interval to delivery was 8.5 days. Maternal outcomes: One abruption, seven chorioamnionitis, two culture positive sepsis requiring high dependency care and no maternal deaths. The CS rate was 33% (10/30) and the instrumental rate 10% (3/30), with one vaginal breech delivery. 15/27 positive high vaginal swabs. Neonatal outcomes: Median Apgar scores at one and at 5 min were 9 and 10 respectively . Mean cord artery pH was 7.31. Average neonatal inpatient stay was 29.61 days (1–209 days). IPPV (9 babies; 2–72 days), CPAP (6 babies; 3–40 days); 2 HFOV. Four required O2 at day 28, two required home oxygen. Eight culture positive sepsis (4 Staphylococcus aureus, 2 Klebsiella, 1 E coli and 1 mixed central nervous system). One neonatal death; 4 babies with intra-ventricular haemorrhage (one of each of the four grades). Conclusion: This group of women and babies are at significant risk of morbidity. Interventions to predict/reduce infection may impact on outcomes.