FETAL HEART-RATE PATTERNS AND FETAL DISTRESS IN PATIENTS WITH PRETERM PREMATURE RUPTURE OF MEMBRANES

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  • 1 January 1984
    • journal article
    • research article
    • Vol. 64  (1) , 60-64
Abstract
Consecutive patients (267) with preterm premature rupture of membranes (PROM) and 130 consecutive patients with idiopathic premature labor and intact membranes between 28 and 35 wk gestation were compared. A significantly higher incidence of cesarean section for fetal distress was found in patients with PROM (7.9%) compared with patients with premature labor (1.5%) (P < 0.05). Fetal distress occurred with similar frequency in patients with and without chorioamnionitis. Analysis of electronic fetal heart rate patterns with fetal distress revealed that 16 of 21 patients (76%) with PROM had patterns consistent with umbilical cord compression. A significant difference was found in neonatal mortality rates between the PROM group (4.5%) and the premature labor group (0) (P < 0.05). The neonatal death rate in patients with fetal distress (3 of 12) was significantly higher than in patients without distress (9 of 385) (P < 0.01). The increased incidence of fetal distress in patients with preterm PROM may represent the loss of the protection of the umbilical cord that amniotic fluid normally provides.