J Clin Gynecol Obstet

Journal of Clinical Gynecology and Obstetrics, ISSN 1927-1271 print, 1927-128X online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Gynecol Obstet and Elmer Press Inc

Journal website http://www.jcgo.org

Original Article

Volume 7, Number 1, March 2018, pages 13-19

Maternal and Perinatal Outcomes Following Expectant Management of Preterm Premature Rupture of Membranes Before 25 Weeks of Gestation: A Retrospective Observational Study

**Table 1.** Maternal Demographics and Pregnancy Characteristics
	Early PPROM: 14+1 - 20 weeks (n = 20) (%)	Late PPROM: 20+1 - 24+6 weeks (n = 21) (%)	P value
All data are expressed as n (%) unless as specified.
Maternal age, years (mean ± SD)	30.3 ± 5.263	31.7 ± 5.963	0.52
Parity (mean ± SD)	1.15 ± 1.725	1.43 ± 1.74	0.61
Gestational age at PPROM, weeks (median, IQR)	17+5 (16+2 - 18+6)	23 (21+3 - 24+1)	< 0.001
Prior PPROM	3 (15)	2 (9.5)	0.59
Prior preterm birth	3 (15)	2 (9.5)	0.59
Cervical insufficiency/short cervix	3 (15)	5 (23.8)	0.24
Cervical encerclage	1 (5)	2 (9.5)	0.57
Current urinary tract infection	4 (20)	4 (19)	0.93
Current vaginal infection	2 (10)	5 (23.8)	0.24
H/O threatened miscarriage	6 (30)	3 (14.3)	0.22
Recent urinary tract infection	5 (25)	2 (9.5)	0.18
Prior first trimester miscarriage	7 (35)	2 (9.5)	0.04
Prior second trimester miscarriage	5 (25)	1 (4.8)	0.06
AFI on admission < 5 cm	6 (30)	10 (47.6)	0.02
AFI on admission < 2 cm	11 (55)	3 (14.3)	0.02
Persistent leaking	11 (55)	13 (61.9)	0.65
OPD follow-up	10 (50)	9 (42.9)	0.64
Antenatal corticosteroids	5 (83.3)	11 (73.3)	0.62

Table 1. Maternal Demographics and Pregnancy Characteristics

Early PPROM: 14+1 - 20 weeks (n = 20) (%)

Late PPROM: 20+1 - 24+6 weeks (n = 21) (%)

P value

All data are expressed as n (%) unless as specified.

Maternal age, years (mean ± SD)

30.3 ± 5.263

31.7 ± 5.963

0.52

Parity (mean ± SD)

1.15 ± 1.725

1.43 ± 1.74

0.61

Gestational age at PPROM, weeks (median, IQR)

17+5 (16+2 - 18+6)

23 (21+3 - 24+1)

< 0.001

Prior PPROM

3 (15)

2 (9.5)

0.59

Prior preterm birth

3 (15)

2 (9.5)

0.59

Cervical insufficiency/short cervix

3 (15)

5 (23.8)

0.24

Cervical encerclage

1 (5)

2 (9.5)

0.57

Current urinary tract infection

4 (20)

4 (19)

0.93

Current vaginal infection

2 (10)

5 (23.8)

0.24

H/O threatened miscarriage

6 (30)

3 (14.3)

0.22

Recent urinary tract infection

5 (25)

2 (9.5)

0.18

Prior first trimester miscarriage

7 (35)

2 (9.5)

0.04

Prior second trimester miscarriage

5 (25)

1 (4.8)

0.06

AFI on admission < 5 cm

6 (30)

10 (47.6)

0.02

AFI on admission < 2 cm

11 (55)

3 (14.3)

0.02

Persistent leaking

11 (55)

13 (61.9)

0.65

OPD follow-up

10 (50)

9 (42.9)

0.64

Antenatal corticosteroids

5 (83.3)

11 (73.3)

0.62

**Table 2.** Maternal and Neonatal Outcomes
	Early PPROM: 14+1 - 20 weeks (n = 20), %	Late PPROM: 20+1 - 24+6 (n = 21), %	P value
All data are expressed as n (%) unless as specified.
Gestational age at delivery, weeks (median, IQR)	19 (17+2 - 25+1)	25 (23 - 27)	0.45
Latency, days (median, IQR)	8 (2 - 56)	12 (3 - 45)	0.76
Cord prolapse	2 (10)	0	0.13
Chorioamnionitis	9 (45)	4 (19)	0.07
Febrile morbidity	3 (15)	1 (4.8)	0.26
Antepartum haemorrhage	2 (10)	3 (14.3)	0.67
Retained placenta	0	3 (14.3)	0.07
Retained products of conception	13 (65)	11 (52.4)	0.41
Surgical evacuation	10 (50)	7 (33.3)	027
Induced delivery	11 (68.1)	7 (38.9)	0.16
LSCS	2 (10)	0	< 0.001
Previable birth	13 (65)	3 (14.3)	0.001
Intrauterine death	0	1 (4.8)	0.32
Intrapartum still birth	0	2 (9.5)	015
Live born	6 (30)	15 (71.4)	0.001
Early neonatal death	2 (10)	8 (38.1)	0.03
Survival to discharge	4 (20)	5 (23.8)	0.76

Table 2. Maternal and Neonatal Outcomes

Early PPROM: 14+1 - 20 weeks (n = 20), %

Late PPROM: 20+1 - 24+6 (n = 21), %

P value

All data are expressed as n (%) unless as specified.

Gestational age at delivery, weeks (median, IQR)

19 (17+2 - 25+1)

25 (23 - 27)

0.45

Latency, days (median, IQR)

8 (2 - 56)

12 (3 - 45)

0.76

Cord prolapse

2 (10)

0.13

Chorioamnionitis

9 (45)

4 (19)

0.07

Febrile morbidity

3 (15)

1 (4.8)

0.26

Antepartum haemorrhage

2 (10)

3 (14.3)

0.67

Retained placenta

3 (14.3)

0.07

Retained products of conception

13 (65)

11 (52.4)

0.41

Surgical evacuation

10 (50)

7 (33.3)

027

Induced delivery

11 (68.1)

7 (38.9)

0.16

LSCS

2 (10)

< 0.001

Previable birth

13 (65)

3 (14.3)

0.001

Intrauterine death

1 (4.8)

0.32

Intrapartum still birth

2 (9.5)

015

Live born

6 (30)

15 (71.4)

0.001

Early neonatal death

2 (10)

8 (38.1)

0.03

Survival to discharge

4 (20)

5 (23.8)

0.76

**Table 3.** Neonatal Outcomes Among Liveborns
	Early PPROM: 14+1 - 20 weeks (n = 6), %	Late PPROM: 20+1 - 24+6 (n = 15), %	P value
All data are expressed as n (%) unless as specified.
Gestational age at PPROM, weeks (mean ± SD)	17.8 ± 1.58	22.8 ± 1.73	< 0.001
Gestational age at delivery, weeks (median, IQR)	33.2 (32 - 34.3)	29.3 (24.5 - 30.1)	0.02
Latency, days (median, IQR)	106 (102 - 112)	74 (5 - 87)	0.36
Birth weight, g (median, IQR)	1,960 (670 - 2,200)	870 (680 - 1,400)	0.02
Received antenatal steroids	5 (83.3)	11 (73.3)	0.62
Male gender	5 (83.3)	6 (40)	0.19
Apgar score < 5 at 5 min	3 (50)	5 (33.3)	0.47
Active rescuscitation needed	1 (16.7)	11 (73.3)	0.01
Human care	2 (33.3)	2 (13.3)	0.29
Length of NICU stay, days (mean ± SD)	4 (5.34)	28 (40.6)	0.01
RDS all grades	5 ( 83.3)	13 (86.7)	0.84
Severe RDS	3 (50)	6 (40)	0.67
O₂ inhalation, days (mean ± SD)	1.67 ± 1.86	17.93 ± 31.3	0.02
Endotracheal ventilation	1 (16.7)	10 (66.7)	0.03
Received surfactant	1 (16.7)	10 (66.7)	0.03
Inotrope support	0	9 (60)	0.01
Sepsis	0	5 (33.3)	0.10
Intraventricular hemorrhage	0	1 (6.7)	0.51
Necrotising enterocolitis	0	2 (13.3)	0.34
Pulmonary hypoplasia	0	1 (6.7)	0.51
Bronchopulmonary dysplasia	0	1 (6.7)	0.51
Periventricular leucomalacia	0	1 (6.7)	0.51
Early neonatal death	2 (33.3)	8 (53.3)	0.40
Survival to discharge	4 (66.7)	5 (33.3)	0.16

Table 3. Neonatal Outcomes Among Liveborns

Early PPROM: 14+1 - 20 weeks (n = 6), %

Late PPROM: 20+1 - 24+6 (n = 15), %

P value

All data are expressed as n (%) unless as specified.

Gestational age at PPROM, weeks (mean ± SD)

17.8 ± 1.58

22.8 ± 1.73

< 0.001

Gestational age at delivery, weeks (median, IQR)

33.2 (32 - 34.3)

29.3 (24.5 - 30.1)

0.02

Latency, days (median, IQR)

106 (102 - 112)

74 (5 - 87)

0.36

Birth weight, g (median, IQR)

1,960 (670 - 2,200)

870 (680 - 1,400)

0.02

Received antenatal steroids

5 (83.3)

11 (73.3)

0.62

Male gender

5 (83.3)

6 (40)

0.19

Apgar score < 5 at 5 min

3 (50)

5 (33.3)

0.47

Active rescuscitation needed

1 (16.7)

11 (73.3)

0.01

Human care

2 (33.3)

2 (13.3)

0.29

Length of NICU stay, days (mean ± SD)

4 (5.34)

28 (40.6)

0.01

RDS all grades

5 ( 83.3)

13 (86.7)

0.84

Severe RDS

3 (50)

6 (40)

0.67

O₂ inhalation, days (mean ± SD)

1.67 ± 1.86

17.93 ± 31.3

0.02

Endotracheal ventilation

1 (16.7)

10 (66.7)

0.03

Received surfactant

1 (16.7)

10 (66.7)

0.03

Inotrope support

9 (60)

0.01

Sepsis

5 (33.3)

0.10

Intraventricular hemorrhage

1 (6.7)

0.51

Necrotising enterocolitis

2 (13.3)

0.34

Pulmonary hypoplasia

1 (6.7)

0.51

Bronchopulmonary dysplasia

1 (6.7)

0.51

Periventricular leucomalacia

1 (6.7)

0.51

Early neonatal death

2 (33.3)

8 (53.3)

0.40

Survival to discharge

4 (66.7)

5 (33.3)

0.16