Management and outcomes of preterm premature rupture of the membranes

Abstract

Purpose of investigation: To compare the maternal and neonatal outcomes of preterm premature rupture of the membranes (PPROM) between two management strategies. Materials and Methods: This retrospective cohort study involved 153 pregnant women who presented with PPROM at a gestational age of 28+0 to 36+6 weeks to evaluate the effects of expectant management (EM; labor > 36 hours) and active management (AM; labor < 36 hours) on maternal and neonatal outcomes. The EM and AM groups were also compared independently of gestational age and after being divided into two subgroups: early PPROM (gestational age 28+0 to 33+6 weeks) and late PPROM (34+0 to 36+6 weeks). Results: There were no differences between the AM and EM groups in the rates of maternal infection or placental abruption, or in neonatal outcomes, including low Apgar scores, respiratory distress syndrome, or the need for continuous positive airway pressure (CPAP). In the early PPROM subgroup, arterial umbilical blood base excess levels were more negative in the AM group (p = 0.007). In the late PPROM subgroup, the change in systolic blood pressure between admission to the maternity care center and membrane rupture was greater in the AM group (p = 0.049). Conclusions: There were no clinically significant differences in the maternal and neonatal outcomes of PPROM between AM and EM.