ABSTRACT
Our objective was to determine the rate of spontaneous version following preterm premature
rupture of membranes (PPROM). Medical charts over a 4-year period were reviewed. All
women with PPROM and singleton gestation between 24 and 34 weeks gestation were included;
65 patients met the inclusion criteria. By ultrasound on admission, 48 were cephalic
16 were breech, and one was transverse lie. Mean amniotic fluid index on admission
was 5.1 ± 4.8 cm (standard deviation) and was not associated with fetal presentation
at delivery. Spontaneous version from cephalic presentation at admission to noncephalic
presentation at delivery occurred in one pregnancy (2.2%). Spontaneous version from
noncephalic presentation at admission to cephalic presentation at delivery occurred
in three pregnancies (17.6%; p = 0.05). Among women with noncephalic presentation at delivery (n = 15), 73.3% had
a cesarean, compared with 23.4% of those with cephalic presentation at delivery (p < 0.05). Spontaneous version, particularly from cephalic to noncephalic presentation,
is unlikely following PPROM.
KEYWORDS
Preterm premature rupture of membranes - spontaneous version - malpresentation
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Linda FonsecaM.D.
Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive
Sciences, University of Texas, Health Science Center Houston
6431 Fannin, 3.604, Houston, TX 77030