Am J Perinatol 2015; 32(01): 057-062
DOI: 10.1055/s-0034-1373846
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Length of Latency with Preterm Premature Rupture of Membranes before 32 Weeks' Gestation

Alan M. Peaceman
1   Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
,
Yinglei Lai
2   Department of Obstetrics and Gynecology, The George Washington University Biostatistics Center, Washington, District of Columbia
,
Dwight J. Rouse
3   Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham Alabama
,
Catherine Y. Spong
4   Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
,
Brian M. Mercer
5   Department of Obstetrics and Gynecology, Case Western Reserve University-MetroHealth Medical Center, Cleveland, Ohio
,
Michael W. Varner
6   Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah
,
John M. Thorp
7   Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
,
Susan M. Ramin
8   Department of Obstetrics and Gynecology, University of Texas Health Science Center at Houston, Houston, Texas
,
Fergal D. Malone
9   Department of Obstetrics and Gynecology, Columbia University, New York, New York
,
Mary J. O'Sullivan
10   Department of Obstetrics and Gynecology, University of Miami, Miami, Florida
,
Gary D.V. Hankins
11   Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas
,
for the Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network › Author Affiliations
Further Information

Publication History

04 December 2013

16 February 2014

Publication Date:
12 May 2014 (online)

Abstract

Objective The objective of the article is to describe latency for patients with preterm premature membrane rupture (PPROM) between 240/7 and 316/7 weeks' gestation.

Study Design Secondary analysis of data collected prospectively in a multicenter clinical trial of magnesium sulfate for cerebral palsy prevention. Women with PPROM and fewer than six contractions per hour at enrollment who were candidates for expectant management (n = 1,377) were included in this analysis. Length of latency was calculated in days by subtracting the time of delivery from the time of membrane rupture.

Results At each week of gestation, median latency between 24 and 28 weeks was similar at approximately 9 days, but it was significantly shorter with PPROM at 29, 30, and 31 weeks (p < 0.001). In addition, the percentage of patients remaining undelivered at 7 days and 14 days was similar for PPROM between 24 and 28 weeks, but it decreased significantly after that. For each gestational age, the proportion of patients remaining pregnant declined in a fashion similar to an exponential pattern.

Conclusion Median latency after PPROM is similar from 24 to 28 weeks' gestation, but it shortens with PPROM at and after 29 weeks.

 
  • References

  • 1 Pasquier J-C, Rabilloud M, Picaud J-C , et al; DOMINOS Group. A prospective population-based study of 598 cases of PPROM between 24 and 34 weeks' gestation: description, management, and mortality (DOMINOS cohort). Eur J Obstet Gynecol Reprod Biol 2005; 121 (2) 164-170
  • 2 Dale PO, Tanbo T, Bendvold E, Moe N. Duration of the latency period in preterm premature rupture of the membranes. Maternal and neonatal consequences of expectant management. Eur J Obstet Gynecol Reprod Biol 1989; 30 (3) 257-262
  • 3 Rouse DJ, Hirtz DG, Thom E , et al; Eunice Kennedy Shriver NICHD Maternal-Fetal Medicine Units Network. A randomized, controlled trial of magnesium sulfate for the prevention of cerebral palsy. N Engl J Med 2008; 359 (9) 895-905
  • 4 Carey JC, Klebanoff MA, Hauth JC , et al; National Institute of Child Health and Human Development Network of Maternal-Fetal Medicine Units. Metronidazole to prevent preterm delivery in pregnant women with asymptomatic bacterial vaginosis. N Engl J Med 2000; 342 (8) 534-540
  • 5 Grimes DA, Nanda K. Magnesium sulfate tocolysis: time to quit. Obstet Gynecol 2006; 108 (4) 986-989
  • 6 Yoon BH, Romero R, Park JS , et al. Fetal exposure to an intra-amniotic inflammation and the development of cerebral palsy at the age of three years. Am J Obstet Gynecol 2000; 182 (3) 675-681
  • 7 Manuck TA, Maclean CC, Silver RM, Varner MW. Preterm premature rupture of membranes: does the duration of latency influence perinatal outcomes?. Am J Obstet Gynecol 2009; 201 (4) e1-e6
  • 8 Melamed N, Ben-Haroush A, Pardo J , et al. Expectant management of preterm premature rupture of membranes: is it all about gestational age?. Am J Obstet Gynecol 2011; 204 (1) e1-e8