Perinatal Outcome in Pregnancies with Extreme Preterm Premature Rupture of Membranes (Mid-Trimester PROM)
Journal Title: Sultan Qaboos University Medical Journal - Year 2013, Vol 13, Issue 1
Abstract
Objectives: Preterm premature rupture of membranes (PPROM) is defned as the rupture of fetal membranes before 37 weeks. Extreme PPROM occurs before 26 weeks’ gestation and can result in perinatal morbidity and mortality. Te aim of this study was to study the perinatal outcomes of mothers with extreme PPROM. Methods: A retrospective cohort study of 44 consecutive pregnant women, presenting with PPROM before 26 weeks’ gestation, was conducted from January 2006 to December 2011 at Sultan Qaboos University Hospital, Oman. Maternal and neonatal information was collected from medical records, and delivery and neonatal unit registries. Women with PPROM presenting after 26 weeks’ gestation, those with multiple gestations, or other types of preterm deliveries were excluded from the study. Results: Of the 44 preterm infants admitted to the Neonatal Intensive Care Unit, 24 (55%) survived, 7 (16%) died within 24 hours of birth, 9 (20%) were miscarried, and 4 (9%) were stillbirths. Neonatal sepsis and pulmonary hypoplasia were the major causes of death. Neonatal complications among the surviving infants included prematurity in 11 (46%), respiratory distress syndrome in 19 (79%), sepsis in 12 (50%), and low birth weight in 11 (46%). Te neonatal survival rate was signifcantly associated with the gestational age at delivery but not with the gestational age upon rupture of membranes. Conclusion: Extreme PPROM was associated with adverse perinatal outcomes. Te results of this study will help obstetricians and neonatologists in counselling couples experiencing PPROM. Future studies of long-term neonatal morbidity should have larger sample sizes and include more hospitals.
Authors and Affiliations
Nihal Al-Riyami| Departments of Obstetrics& Gynecology, Sultan Qaboos University Hospital, Muscat, Oman, Fatma Al-Shezawi| College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman, Intisar Al-Ruheili| College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman, Tamima Al-Dughaishi| Departments of Obstetrics& Gynecology, Sultan Qaboos University Hospital, Muscat, Oman, Murtadha Al-Khabori| Department of Haematology, Sultan Qaboos University Hospital, Muscat, Oman
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