Preterm premature rupture of the membranes: neonatal outcome in 215 cases of an active conservative management

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Abstract
The aim of the study is to evaluate an active conservative management (tocolysis and antibiotics administration) in preterm premature rupture of the membranes (ROM), applied to 215 singleton pregnancies. Pregnancies are continuated until 37 weeks of gestation if the clinical and biological follow-up shows no risk for the mother and the fetus. The neonatal results were analysed by statistical methods and were compared to the outcome of a control group of premature neonates. Our results show that the outcome is mostly determined by gestational age at membrane rupture. No benefit nor risk was added when glucocorticoids were administrated. Clinical suspicion of chorioamnionitis increases the risk of neonatal infection. A prolonged latency period (.gtoreq. 7 days) does not increase the maternal or fetal infection risk. When birth happened before 35 weeks and before 37 weeks, the premature neonate after PROM has a lower incidence of hyaline membrane disease and neonatal death compared with the control group. These results are in favor of an active conservative managment in PROM.