ABSTRACT
Very premature and prolonged rupture of the membranes (VPPROM) for at least 5 days
is associated with an increased incidence of perinatal infection and lung hypoplasia.
There is, however, limited information about outcome of premature neonates born after
VPPROM uncomplicated by oligohydramnios. The present study compared the outcome, in
three categories of neonates born before 34 weeks gestation: group I, VPPROM without
oligohydramnios (n = 28); group II, VPPROM with oligohydramnios (n = 14); and group
III, the comparison group without VPPROM (n = 39). Mortality in group I (2 of 28)
was similar to that in group III (6 of 39) and was lower than that in group II (5
of 14). Lung hypoplasia and limb deformities were not more frequent in group I than
in group III (2 of 28 and 0 of 28 versus 3 of 39 and 1 of 39, respectively) but occurred
more frequently only in group II (5 of 14 and 4 of 14). All deaths in groups I and
II were accounted for by lung hypoplasia. There was no difference between the groups
for asphyxia, (respiratory distress syndrome, air leaks, bronchiopulmonary dysplasia,
or intracranial bleeding. Neonatal infection was more frequent in group I (4 of 14,
28.6%) and group II (7 of 28, 25%) when compared with group III (2 of 39, 5%). Within
groups I and II rupture of the membranes was not more prolonged in the neonates with
infection (median, 9.7 days) compared with the neonates without infection (median,
9.6 days). In conclusion, when VPPROM is not complicated by oligohydramnios, mortality,
lung hypoplasia, and limb deformities are not more frequent than in control neonates
of similar gestational age. As shown by others, the present data support the fact
that VPPROM is associated with an increased risk of perinatal infection, but this
is not responsible for the poor outcome.
