Abstract
Objective: To identify factors influencing the outcome of premature infants delivered after
prolonged premature rupture of membranes before 25 weeks’ gestation. Design and population: All premature infants with gestational age <34 weeks, either inborn or outborn, with
history of rupture of membranes before 25 weeks’ gestation, admitted to our NICU between
January 1992 and July 1997, were eligible for this retrospective study. Collected
information included birth weight, gestational age at rupture of membranes and at
delivery, duration between rupture of membranes and delivery (latency period), severity
of oligohydramnios, pre- and post-natal managements, and follow-up of survivors. Results: A total of 28 neonates fulfilled the inclusion criteria. Despite new strategies of
ventilation and optimal management, the overall mortality rate was 43% (12/28). Nonsurvivors
were significantly less mature at rupture of membranes, and had severe oligohydramnios
(anamnios). We also noted less antenatal corticosteroids and antibiotic therapy in
this group. Nine of eleven infants (82%) following rupture of membranes before 22
weeks’ gestation died shortly after birth. The two remaining infants developed severe
bronchopulmonary dysplasia. Nine deaths occurred in thirteen cases (69%) of anamnios.
The major death causes were refractory respiratory failure and neurologic complications.
Half of all survivors (8/16) developed bronchopulmonary dysplasia. Conclusion: The outcome of premature infants following prolonged premature rupture of membranes
before 25 weeks’ gestation is influenced by gestational age at rupture, severity of
oligohydramnios, and antenatal antibiotics and corticosteroids. Neonates with rupture
of membranes before 22 weeks have a very low chance of survival at the present time.
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Article info
Publication history
Accepted:
August 20,
1999
Received:
November 3,
1998
Identification
Copyright
© 2000 Elsevier Science Ireland Ltd. Published by Elsevier Inc. All rights reserved.
