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Maternal and neonatal outcomes in preterm prelabour rupture of membranes between 24 and 34 weeks gestation
  1. V Sephton,
  2. A Redfern,
  3. D Roberts
  1. Liverpool Women's Hospital, Liverpool, UK

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.

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