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PP.89 Preterm Pre-Labour Rupture of Membranes (PPROM) – When Clinicians Aspire to Find a Balance
  1. S Islam,
  2. S Hickey,
  3. S Hamilton
  1. Calderdale Royal Hospital, HALIFAX, UK

Abstract

Introduction and objectives Preterm Pre-labour Rupture of Membranes complicates 2% of all pregnancies and is related to 40% of all preterm deliveries with significant neonatal and maternal risks. Balancing the risks between prematurity and maternal/fetal infection can pose difficult dilemmas for obstetricians. This study collected data on PPROM-delivery interval, maternal and fetal outcomes and examined the impact of inter-clinician variation in practise on clinical outcomes.

Methodology This retrospective observational study included 48 women with PPROM before 36 weeks of gestation between January 2011 and April 2012 at Calderdale Royal Hospital.

Results All patients with confirmed PPROM received erythromycin and steroid. Incidence of gestation <34 weeks at PPROM was 40%; of delivery at <34 weeks was 28%. Prolongation of pregnancy of 2–7 days occurred in 52%, 7–14 days in 2% and >14 days in 13%. Timing of induction of labour (IOL) varied from 34 to 36 + 6 weeks although without any adverse outcomes. There were two neonatal deaths (NND) following spontaneous labour.

Conclusion Prolongation of pregnancy of 48 hours or more occurred in a significant percentage of patients with conservative management. Prematurity played a crucial role in the two instances of NND. It is not clear that outcomes would have been different with different clinical management. This series shows that PPROM caries significant threat to perinatal outcome even with optimum obstetric care.

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