Premium
Comparison of perinatal outcome after pre‐viable preterm prelabour rupture of membranes in two centres with different rates of termination of pregnancy
Author(s) -
Azria E,
Anselem O,
Schmitz T,
Tsatsaris V,
Senat MV,
Goffinet F
Publication year - 2012
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.2011.03265.x
Subject(s) - medicine , gestation , rupture of membranes , obstetrics , gestational age , pregnancy , retrospective cohort study , gynecology , surgery , genetics , biology
Please cite this paper as: Azria E, Anselem O, Schmitz T, Tsatsaris V, Senat M, Goffinet F. Comparison of perinatal outcome after pre‐viable preterm prelabour rupture of membranes in two centres with different rates of termination of pregnancy. BJOG 2012;119:449–457. Objective To assess perinatal outcomes after expectant management in the case of preterm prelabour rupture of membranes (PPROM) before 25 weeks of gestation, according to the rate of termination of pregnancy (TOP). Design Retrospective comparative cohort study. Population Singleton pregnancies complicated by PPROM between 15 0/7 and 24 6/7 weeks of gestation, from January 2003 to January 2007. Methods Comparison of perinatal outcomes in two French tertiary care referral centres presumed to have different rates of TOP. Main outcome measure Rates of TOP, survival and survival without major morbidity. Results A total of 113 women experienced PPROM (49 in centre A and 64 in centre B). A lower proportion of patients opted for TOP in centre A (40.8%) than in centre B (56.3%). The baseline characteristics of patients and pregnancies, and gestational age at PPROM, were not different between the two centres. Mean gestational age at delivery (28.1 versus 25.4 weeks of gestation; P < 0.01), mean latency period (45.5 versus 16.1 days; P < 0.01), mean birthweight (1295 versus 929 g; P = 0.04) and survival (46.9 versus 20.3%; P < 0.01) were significantly higher in centre A than in centre B. The percentage of neonates alive without major morbidity was also higher in centre A than in centre B (42.9 versus 20.3%; P = 0.01). Conclusions Perinatal outcomes of pregnancies managed expectantly were not better in the centre where the TOP rate was higher. The perinatal risk of pregnancies complicated by pre‐viable PPROM remains high.