D Indications of Pregnancy Termination in Patients Admitted with Preterm Premature Rupture of Membranes and Their Associations with Neonatal Outcomes

Abstract

Although Preterm Premature Rupture of Membranes (PPROM) occurs in 1–2% of pregnancies, it accounts for 30–40% of preterm births. PPROM can result in placental abruption, umbilical cord compression, umbilical cord prolapses and abrupt amniotic fluid withdrawal, and cause many serious complications for both the fetus /neonate (such as death, musculoskeletal disorders, lung hypoplasia and respiratory depression) and mother (such as death, endometritis and chorioamnionitis). Therefore, so we aimed to determine the indications of termination of pregnancy and their associations with neonatal outcomes among the pregnant women hospitalized with PPROM to Taleghani and Alzahra teaching hospitals of Tabriz.

Methods & Materials: This prospective cohort study was performed over a number of 199 pregnant women with PPROM who were admitted to Taleghani and Alzahra teaching hospitals of Tabriz during 2018-2019. At the time of admission, patients were allocated to two main groups: under 30 weeks (first group) and 30 weeks and above (second group). Data on indications of termination of pregnancy, amniotic fluid index, fetal presentation, and total days of patients’ hospitalization till delivery were collected for each study group and then their associations with neonatal complications were evaluated within each group. Results: In this study, 199 women with a mean age of 29.3±6.4 years were included. Delivery and progression were the most common indication of termination of pregnancy in both study groups, and emergency and cesarean deliveries were more common in the first group than in the second one. The most common maternal complication was chorioamnionitis with a frequency of 3 (1.5%) cases, which was more common in the women of first group. For neonatal complications, PVH, IVH and seizure were the most common complications, respectively. The neonatal complications were also more common in the infants of first group. In addition, a total of 27 neonatal deaths occurred, of which 20 were in the first group and 7 in the second group. In both groups, there were no significant relationships between the indications of termination of pregnancy and the probable influencing factors (such as days of patients’ hospitalization till delivery) with incidence of neonatal complications. Conclusion: