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Conservative management of premature rupture of the membrane
Management recommendations for pregnancies complicated by premature rupture of the membranes must consider both the neonatal morbidity and mortality of immaturity associated with prompt delivery and the infectious risks to the mother and fetus associated with prolonged observation. Because these considerations are critical in pregnancies with prematurely ruptured membranes and premature but potentially viable infants, 116 pregnancies with this complication between 28 and 36 weeks' gestation were reviewed. All patients received careful in-hospital surveillance. Six patients (5.2%) developed amnionitis prior to labor. Nine infants (7.1%) developed neonatal sepsis, with the predominant pathogen being the group B beta-hemolytic streptococcus. A decrease in the incidence of respiratory distress syndrome (RDS) and patent ductus arteriosus (PDA) with progressive duration of membrane rupture was observed. The perinatal survival in this study was 96.9%. These findings suggest that in similar patient populations an expectant management plan may be employed with minimal infectious risks to mother and fetus.
Management recommendations for pregnancies complicated by premature rupture of the membranes must consider both the neonatal morbidity and mortality of immaturity associated with prompt delivery and the infectious risks to the mother and fetus associated with prolonged observation. Because these considerations are critical in pregnancies with prematurely ruptured membranes and premature but potentially viable infants, 116 pregnancies with this complication between 28 and 36 weeks' gestation were reviewed. All patients received careful in-hospital surveillance. Six patients (5.2%) developed amnionitis prior to labor. Nine infants (7.1%) developed neonatal sepsis, with the predominant pathogen being the group B beta-hemolytic streptococcus. A decrease in the incidence of respiratory distress syndrome (RDS) and patent ductus arteriosus (PDA) with progressive duration of membrane rupture was observed. The perinatal survival in this study was 96.9%. These findings suggest that in similar patient populations an expectant management plan may be employed with minimal infectious risks to mother and fetus.