Placental histology and clinical characteristics of patients with preterm premature rupture of membranes.

OBJECTIVE

To analyze the placental histology in cases of preterm premature rupture of membranes (PROM), classify the cases according to the results of the histologic examination, and determine if these histologic groups have different clinical characteristics and outcomes.

METHODS

During a 3-year period, a cohort of 235 women with preterm PROM was studied prospectively. The women were classified according to placental histologic findings, and their prenatal and intrapartum courses and perinatal mortality and morbidity were analyzed and compared.

RESULTS

One hundred two placentas (43.4%) exhibited acute inflammatory lesions, 48 (20.4%) had vascular lesions, 48 (20.4%) had both inflammatory and vascular lesions, 31 (13.2%) had no abnormal findings, four (1.7%) had villous edema, and two (0.8%) had chronic villitis. The four largest histologic groups had distinctive characteristics with respect to gestational age at the time of PROM and at delivery, duration of the latency period, and perinatal mortality and morbidity.

CONCLUSION

Cases of preterm PROM may be classified according to placental histologic findings, and these groups have different clinical manifestations, prognoses, and outcomes.