Maternal and neonatal outcomes based on the gestational age of midtrimester preterm premature rupture of membranes

Objectives. Determine neonatal and maternal outcomes based on the gestational age (GA) that midtrimester preterm premature rupture of membranes (mtPPROM) occurs. Study design. A retrospective chart review was conducted on pregnancies with mtPPROM between 180/7 and 236/7 weeks gestation from January 2000 to December 2007. Antenatal complications, maternal morbidity, and neonatal survival and morbidity were analysed by the specific GA of mtPPROM. Statistical analysis was performed using Chi-square, Fisher's Exact, and Kruskal-Wallis tests. Results. A total of 105 patients met inclusion criteria. There was a trend for longer latency with earlier GA of mtPPROM (p = 0.05). Neonatal survival to discharge was 26.6%, with an overall morbidity of 86%. Survival was significantly higher with mtPPROM at 22 0/7-23 6/7 weeks compared to 18 0/7-19 6/7 (p = 0.01) and 20 0/7-21 6/7 weeks (p = 0.01). There was no difference in neonatal morbidity based on the GA of mtPPROM. Conclusions. While neonatal survival improves at later GAs of mtPPROM, morbidity continues to be high.