Document Detail


Survival and 2-year outcome with expectant management of second-trimester rupture of membranes.
MedLine Citation:
PMID:  9840545     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the perinatal and 2-year outcomes in pregnancies complicated by preterm premature rupture of membranes (PROM) during the second trimester. METHODS: Fifty-three consecutive singleton pregnancies with PROM at 14 to 28 weeks of gestation were studied retrospectively. Management goals were to prolong the pregnancies to 32 weeks through expectant management and to avoid fetal compromise through closer monitoring and active intervention, when necessary, after 23 weeks. Outcome of the surviving infants was based on neurologic, audiometric, and ophthalmologic examinations at 2 years of corrected age. RESULTS: Rupture of membranes occurred at 14-19 weeks (mean 17.4 weeks) in 10 women, at 20-25 weeks (mean 24.0 weeks) in 24, and at 26-28 weeks (mean 27.6 weeks) in 19. The median latency periods to delivery were 72 days, 12 days, and 10 days when rupture of membranes occurred at 14-19 weeks, 20-25 weeks, and 26-28 weeks, respectively. The overall incidence of chorioamnionitis was 28%. There were no fetal deaths and nine neonatal deaths. When rupture of membranes occurred at 14-19 weeks, 20-25 weeks, and 26-28 weeks, the perinatal survival rates were 40%, 92%, and, 100%, respectively. Pulmonary hypoplasia accounted for seven deaths. Of the live-born infants, 81% were alive at 2 years of corrected age. Survival without major impairment was observed in 75%, 80%, and 100% of the survivors when rupture of membranes occurred at 14-19 weeks, 20-25 weeks, and 26-28 weeks, respectively. CONCLUSION: Expectant management of second-trimester PROM offers better perinatal and long-term survival than previously thought.
Authors:
A Farooqi; P A Holmgren; S Engberg; F Serenius
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  92     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  1998 Dec 
Date Detail:
Created Date:  1998-12-29     Completed Date:  1998-12-29     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  895-901     Citation Subset:  AIM; IM    
Affiliation:
Department of Pediatrics, Umea University Hospital, Sweden. afarooqi.us@vll.se
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MeSH Terms
Descriptor/Qualifier:
Adult
Female
Fetal Membranes, Premature Rupture / complications,  therapy*
Gestational Age
Humans
Infant, Newborn
Infant, Premature, Diseases / mortality*
Pregnancy
Pregnancy Trimester, Second
Retrospective Studies
Survival Rate
Time Factors
Treatment Outcome
Comments/Corrections
Comment In:
Obstet Gynecol. 1999 Apr;93(4):632-3   [PMID:  10214851 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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