Temporal trends of latency period and perinatal survival after very early preterm premature rupture of fetal membranes.

PURPOSE

This paper shows temporal trends of latency period and perinatal survival after preterm premature rupture of membranes at or before 28 weeks (very early PPROM).

METHODS

We have studied retrospectively medical records of all cases of very early PPROM attended in our Obstetric Department from January 1, 2000 to December 31, 2010.

RESULTS

A total of 327 cases of very early PPROM were attended, representing 0.4 % of all deliveries, 3.68 % of all preterm births and 15 % of cases all of PPROM. The mean gestational age at delivery was 27 weeks (range 20-34). The mean duration of latency period for the total of 327 cases was 12.1 days (range 0-83, SD 13.3), with a clear trend to its increase from 2005 (p < 0.05). The mean duration of latency period was largest in 2010 (p < 0.05). For the whole period 2000-2010, perinatal deaths reached 30.6 % of all cases, with a clear trend to decrease as gestational age at diagnosis increased, and over the years of study. We have also found a high rate of obstetric complications and a high rate of cesarean deliveries.

CONCLUSIONS

The upward trend in the duration of latency period in all groups over the years of study and the encouraging perinatal survival observed, even in previable PPROM, are incentives to follow expectant/conservative management in these cases.