Length of Latency with Preterm Premature Rupture of Membranes before 32 Weeks' Gestation

Alan M. Peaceman; Yinglei Lai; Dwight J. Rouse; Catherine Y. Spong; Brian M. Mercer; Michael W. Varner; John M. Thorp; Susan M. Ramin; Fergal D. Malone; Mary J. O'Sullivan; Gary D.V. Hankins; for the Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network

doi:10.1055/s-0034-1373846

American Journal of Perinatology, Inhaltsverzeichnis

Am J Perinatol 2015; 32(01): 057-062
DOI: 10.1055/s-0034-1373846

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Length of Latency with Preterm Premature Rupture of Membranes before 32 Weeks' Gestation

Authors

Alan M. Peaceman

¹Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
Yinglei Lai

²Department of Obstetrics and Gynecology, The George Washington University Biostatistics Center, Washington, District of Columbia
Dwight J. Rouse

³Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham Alabama
Catherine Y. Spong

⁴ Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
Brian M. Mercer

⁵Department of Obstetrics and Gynecology, Case Western Reserve University-MetroHealth Medical Center, Cleveland, Ohio
Michael W. Varner

⁶Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah
John M. Thorp

⁷Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
Susan M. Ramin

⁸Department of Obstetrics and Gynecology, University of Texas Health Science Center at Houston, Houston, Texas
Fergal D. Malone

⁹Department of Obstetrics and Gynecology, Columbia University, New York, New York
Mary J. O'Sullivan

¹⁰Department of Obstetrics and Gynecology, University of Miami, Miami, Florida
Gary D.V. Hankins

¹¹Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas

for the Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network

Abstract

Objective The objective of the article is to describe latency for patients with preterm premature membrane rupture (PPROM) between 24^0/7 and 31^6/7 weeks' gestation.

Study Design Secondary analysis of data collected prospectively in a multicenter clinical trial of magnesium sulfate for cerebral palsy prevention. Women with PPROM and fewer than six contractions per hour at enrollment who were candidates for expectant management (n = 1,377) were included in this analysis. Length of latency was calculated in days by subtracting the time of delivery from the time of membrane rupture.

Results At each week of gestation, median latency between 24 and 28 weeks was similar at approximately 9 days, but it was significantly shorter with PPROM at 29, 30, and 31 weeks (p < 0.001). In addition, the percentage of patients remaining undelivered at 7 days and 14 days was similar for PPROM between 24 and 28 weeks, but it decreased significantly after that. For each gestational age, the proportion of patients remaining pregnant declined in a fashion similar to an exponential pattern.

Conclusion Median latency after PPROM is similar from 24 to 28 weeks' gestation, but it shortens with PPROM at and after 29 weeks.

Keywords

latency - premature rupture of membranes - preterm birth

Volltext

Referenzen

References
1 Pasquier J-C, Rabilloud M, Picaud J-C , et al; DOMINOS Group. A prospective population-based study of 598 cases of PPROM between 24 and 34 weeks' gestation: description, management, and mortality (DOMINOS cohort). Eur J Obstet Gynecol Reprod Biol 2005; 121 (2) 164-170
2 Dale PO, Tanbo T, Bendvold E, Moe N. Duration of the latency period in preterm premature rupture of the membranes. Maternal and neonatal consequences of expectant management. Eur J Obstet Gynecol Reprod Biol 1989; 30 (3) 257-262
3 Rouse DJ, Hirtz DG, Thom E , et al; Eunice Kennedy Shriver NICHD Maternal-Fetal Medicine Units Network. A randomized, controlled trial of magnesium sulfate for the prevention of cerebral palsy. N Engl J Med 2008; 359 (9) 895-905
4 Carey JC, Klebanoff MA, Hauth JC , et al; National Institute of Child Health and Human Development Network of Maternal-Fetal Medicine Units. Metronidazole to prevent preterm delivery in pregnant women with asymptomatic bacterial vaginosis. N Engl J Med 2000; 342 (8) 534-540
5 Grimes DA, Nanda K. Magnesium sulfate tocolysis: time to quit. Obstet Gynecol 2006; 108 (4) 986-989
6 Yoon BH, Romero R, Park JS , et al. Fetal exposure to an intra-amniotic inflammation and the development of cerebral palsy at the age of three years. Am J Obstet Gynecol 2000; 182 (3) 675-681
7 Manuck TA, Maclean CC, Silver RM, Varner MW. Preterm premature rupture of membranes: does the duration of latency influence perinatal outcomes?. Am J Obstet Gynecol 2009; 201 (4) e1-e6
8 Melamed N, Ben-Haroush A, Pardo J , et al. Expectant management of preterm premature rupture of membranes: is it all about gestational age?. Am J Obstet Gynecol 2011; 204 (1) e1-e8