Mousiolis Athanasios, Papantoniou Nikolaos, Mesogitis Spyros, Baglatzi Labrini, Baroutis Giorgos, Antsaklis Aris
1st Obstetrics and Gynecology Clinic, University Hospital Alexandra, Athens, Greece.
J Matern Fetal Neonatal Med. 2012 Jul;25(7):1044-9. doi: 10.3109/14767058.2011.614659. Epub 2011 Oct 4.
To provide evidence about the preferable mode of delivery, vaginal (VD) or caesarean section (CS), in PPROM.
A retrospective study of 190 cases. Survival analysis was used to identify statistically significant differences in mortality rates.
A total of 126 pregnancies were included in our study. Mean gestational age of rupture was 28(+0) weeks (min = 15, max = 36(+4), sd = 5.796). Mean birth age was 30(+0) weeks (min = 15, max = 37(+2), sd = 5.353). CS was performed in 55 cases (43.7%), VD in 71 cases (56.3%). Data analysis showed that, regardless of presentation, there was a statistically significant benefit on survival in favor of the CS in births below 30 gestational weeks (n = 39, nCS = 18, nND = 21, χ(2) = 7.946, p = 0.005). Hazard ratio estimation set the critical gestational age at 28 weeks. For vaginal deliveries, breech presentation was associated with inferior survival outcome compared to vertex (nTotal = 71; nVertex = 63, nBreech = 8, χ(2) = 13.012, p < 0.001.Also in breech presentation, VD survival outcome was inferior to CS (nTotal = 9; nVD = 6, nCS = 3, χ(2) = 5.145, p < 0.05).
According to our results, in cases of PPROM, CS was beneficial below 28 weeks and in breech presentation below 30 weeks.
