Perinatal Outcome with Active Expectant Management of Second-Trimester Rupture of Membranes / 대한산부인과학회잡지

ABSTRACT

OBJECTIVE: The purpose of this study was to evaluate the perinatal outcomes in pregnancies complicated by preterm premature rupture of membranes (PROM) during the second trimester. METHODS: Thirty-two consecutive pregnancies with PROM at 20-28 weeks of gestation were studied retrospectively. The goals of management were to prolong the pregnancies to 32 weeks through active expectant management and to avoid fetal compromise through close monitoring and active intervention. All medical records of mothers and neonates were reviewed. RESULTS: Total 30 pregnant women with rupture of membranes at 20-28 weeks were included. Rupture of membranes occurred at 20-25 weeks(mean 24.2) in 14 women and at 26-28 weeks(mean 27.2) in 16 women. The median latency periods to delivery were 309 hours and 234 hours when rupture of membranes occurred at 20-25 weeks and at 26-28 weeks, respectively. Overall incidences of clinical and histologic chorioamnionitis were 10% and 72%. There were no fetal deaths and 8 neontal deaths. When rupture of membranes occurred at 20-25 weeks and at 26-28 weeks, the perinatal survival rates were 50% and 94%, respectively. CONCLUSION: Active expectant management of second-trimester PROM offers better perinatal survival than previously thought.