Perinatal Outcomes of Pregnancies with Preterm Premature Rupture of Membranes after 34 Weeks of Gestation

Background: Preterm premature rupture of the membranes (PPROM) is an important contributor to perinatal mortality and morbidity. Neonatal complications are related primarily to the gestational age at rupture of membranes.
Objective: The aim of the present study was to improve the perinatal maternal and fetal/neonatal outcomes in cases with preterm premature rupture of membranes between 34 -37 weeks of gestations.
Patients and methods: This prospective case control study included 82 women comprised 41 with PPROM (group I) and 41 without ROM as matched controls (group II). All women were presented to maternity unit of Obstetrics and Gynecology Department over 8 months period, at Zagazig University Hospitals.
Results: In this study (73.2%) with PPROM were below the age of 30 years. Urinary tract infection was 17.1% versus 12.2 %, cervicitis 4.9% versus 0% in patients with PPROM versus controls respectively. Maternal outcome in this study was evaluated; there were 82.9% of patients with PPROM versus 95.1% discharged from hospital within 4 days after delivery with no bad outcomes. Good Apgar score was (68.3%) in patients with PPROM and 82.9% in control group. In PPROM group; 7 fetuses were diagnosed as fetal distress and only 2 (4.9%) cases had clinical chorioamnionitis. Regarding neonatal morbidity in patients with PPROM, the results showed that respiratory distress syndrome (RDS) was diagnosed in 4 neonates, 7 with tachypnea, 6 with jaundice, and 3 with sepsis and no case of perinatal mortality.
Conclusion: With appropriate care, the maternal risks of expectant management after 34 weeks of gestation are generally accepted to be minimal and a clear neonatal advantage exists by reducing risks of neonatal respiratory problems, admission for neonatal intensive care, and cesarean section.