Conservative management of preterm premature rupture of membranes beyond 32 weeks’ gestation: Is it worthwhile?

Abstract

We aimed to investigate whether conservative management of preterm premature rupture of membranes (PPROM) at 32–34 weeks’ gestation improves outcome. In this retrospective analysis of singleton pregnancies, the study group included patients with PPROM at 28–34 weeks’ gestation and the control group included patients presented with spontaneous preterm delivery at 28–34 weeks’ gestation. Both groups were subdivided according to gestational age – early (28–31 weeks’ gestation) versus late (32–34 weeks’ gestation). Adverse neonatal outcome included neonatal death, intraventricular haemorrhage grade 3/4, respiratory distress syndrome, periventricular leucomalacia and neonatal sepsis. The study and control groups included 94 and 86 women, respectively. The study group had a lower incidence of adverse neonatal outcome at the earlier weeks (28–31), compared with the control group at the same gestational age. In contrast, at 32–34 weeks’ gestation no difference in the risk for adverse neonatal outcome was noticed. Additionally, within the study group, chorioamnionitis rate was significantly higher among those who delivered at 32–34 weeks’ gestation (p < 0.01). No advantage for conservative management of PPROM was demonstrated beyond 31 weeks’ gestation. Moreover, conservative management of PPROM at 32–34 weeks’ gestation may expose both mother and neonate to infectious morbidity.

Keywords::

• Conservative management
• chorioamnionitis
• outcome
• preterm premature rupture of membranes

Acknowledgments

We thank Esther Eshkol, the institutional medical and scientific copyeditor.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.