Wagner Philipp, Sonek Jiri, Mayr Stefanie, Abele Harald, Goelz Rangmar, Hoopmann Markus, Kagan Karl Oliver
Department of Obstetrics and Gynaecology, University of Tuebingen, Germany.
Fetal Medicine Foundation USA, Dayton, OH, USA; Division of Maternal Fetal Medicine, Wright State University, Dayton, OH, USA.
Eur J Obstet Gynecol Reprod Biol. 2016 Aug;203:121-6. doi: 10.1016/j.ejogrb.2016.05.018. Epub 2016 May 20.
To examine the contemporary outcome in women with rupture of membranes (PPROM) before 24+0 weeks' gestation.
Retrospective analysis of women with spontaneous PPROM before 24+0 weeks that were treated at the University of Tuebingen/Germany. The search of the database included common maternal and pregnancy characteristics as well as the neonatal outcomes.
One hundred and one pregnancies fulfilled the inclusion criteria. 32 (31.7%) women opted for termination of pregnancy, which were excluded from further analysis. The gestational age at PPROM in the 69 women with an expectant management was 21.3 (IQR 19.1-22.6) weeks. 40 (58.0%) pregnancies carried on beyond 24+0 weeks. Multiple regression analysis indicated that the time of PPROM and the absence of oligo-/anhydramnios were associated with a prolongation beyond 24+0 weeks. In the 40 pregnancies that remained intact beyond 24+0 weeks' gestation, the fetuses were born at 27.7 (IQR 25.3-30.9) weeks. Survival without major complications was observed in 22 (55.0%) fetuses. Multiple regression analysis indicated that only the gestational age at the time of delivery was significantly associated with such an intact survival.
In cases with PPROM there is a 60% chance of a prolongation beyond 24+0 weeks. About half of these fetuses will be discharged alive without major complications.
研究妊娠24+0周前胎膜早破（PPROM）女性的当代结局。
对德国图宾根大学治疗的妊娠24+0周前发生自发性PPROM的女性进行回顾性分析。数据库检索内容包括常见的母亲和妊娠特征以及新生儿结局。
101例妊娠符合纳入标准。32例（31.7%）女性选择终止妊娠，被排除在进一步分析之外。69例接受期待治疗的女性发生PPROM时的孕周为21.3（四分位间距19.1 - 22.6）周。40例（58.0%）妊娠持续至24+0周以后。多元回归分析表明，PPROM发生时间以及无羊水过少/羊水过少与妊娠持续至24+0周以后有关。在妊娠持续至24+0周以后的40例妊娠中，胎儿在27.7（四分位间距25.3 - 30.9）周出生。22例（55.0%）胎儿存活且无严重并发症。多元回归分析表明，只有分娩时的孕周与这种完整存活显著相关。
在PPROM病例中，有60%的机会妊娠持续至24+0周以后。这些胎儿中约一半将存活出院且无严重并发症。
