Neonatal and maternal outcomes following midtrimester preterm premature rupture of the membranes: a retrospective cohort study

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dc.contributor.authorLinehan, Laura Aoife
dc.contributor.authorWalsh, Jennifer
dc.contributor.authorMorris, Aoife
dc.contributor.authorKenny, Louise C.
dc.contributor.authorO'Donoghue, Keelin
dc.contributor.authorDempsey, Eugene M.
dc.contributor.authorRussell, Nóirín
dc.date.accessioned2017-02-22T16:17:05Z
dc.date.available2017-02-22T16:17:05Z
dc.date.issued2016-01
dc.date.updated2017-02-22T16:09:48Z
dc.description.abstractBackground: Preterm premature rupture of membranes (PPROM) complicates 1 % of all pregnancies and occurs in one third of all preterm deliveries. Midtrimester PPROM is often followed by spontaneous miscarriage and elective termination of ongoing pregnancies is offered in many countries. The aim of this retrospective descriptive cohort study was to investigate the natural history of midtrimester PPROM in a jurisdiction where termination of pregnancy in the absence of maternal compromise is unavailable. Methods: Cases of midtrimester PPROM diagnosed between 14 and 23 + 6 weeks’ gestation during April 2007 to June 2012 were identified following a manual search of all birth registers, pregnancy loss registers, annual reports, ultrasound reports, emergency room registers and neonatal death certificates at Cork University Maternity Hospital - a large (circa 8500 births per annum) tertiary referral maternity hospital in southwest Ireland. Cases where delivery occurred within 24 h of PPROM were excluded. Results: The prevalence of midtrimester PPROM was 0.1 % (42 cases/44,667 births). The mean gestation at PPROM was 18 weeks. The mean gestation at delivery was 20 + 5 weeks, with an average latency period of 13 days. Ten infants were born alive (23 %; 10/42). The remainder (77 %; 32/42) died in utero or intrapartum. Nine infants were resuscitated. Two infants survived to discharge. The overall mortality rate was 95 % (40/42). Five women had clinical chorioamnionitis (12 %; 5/42) but 69 % demonstrated histological chorioamnionitis. One woman developed sepsis (2.4 %; 1/42). Other maternal complications included requirement of intravenous antibiotic treatment (38 %; 17/42), retained placenta (21 %, 9/42) and post-partum haemorrhage (12 %; 5/42). Conclusions: This study provides useful and contemporary data on midtrimester PPROM. Whilst fetal and neonatal mortality is high, long-term survival is not impossible. The increased risk of maternal morbidity necessitates close surveillance.en
dc.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationLinehan, L. A., Walsh, J., Morris, A., Kenny, L., O’Donoghue, K., Dempsey, E. and Russell, N. (2016) 'Neonatal and maternal outcomes following midtrimester preterm premature rupture of the membranes: a retrospective cohort study', BMC Pregnancy and Childbirth, 16(1), pp. 25. doi:10.1186/s12884-016-0813-3en
dc.identifier.doi10.1186/s12884-016-0813-3
dc.identifier.endpage25-7en
dc.identifier.issn1471-2393
dc.identifier.issued1en
dc.identifier.journaltitleBMC pregnancy and childbirthen
dc.identifier.startpage25-1en
dc.identifier.urihttps://hdl.handle.net/10468/3674
dc.identifier.volume16en
dc.language.isoenen
dc.publisherBioMed Centralen
dc.rights© 2016 Linehan et al. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.en
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/en
dc.subjectPreterm birthen
dc.subjectPreterm premature rupture of membranesen
dc.subjectSepsisen
dc.titleNeonatal and maternal outcomes following midtrimester preterm premature rupture of the membranes: a retrospective cohort studyen
dc.typeArticle (peer-reviewed)en
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