Predictive factors for neonatal survival in women with periviable preterm rupture of the membranes.

Barbara Acaia, Francesca Crovetto, Manuela W. Ossola, Silvia Nozza, Giulia Maria Baffero, Edgardo Somigliana, Carlo Pietrasanta, Lorenza Pugni, Fabio Mosca, Luigi Fedele

Research output: Contribution to journalArticle

Abstract

To identify clinical, hematological or instrumental factors available at the time of the diagnosis that may predict neonatal survival in periviable preterm premature rupture of the membranes (PROM). We report on a cohort (n = 85) of women with periviable PROM (14-23.6 weeks' gestation) occurring over a 10-year period in a single institution. The main outcome chosen was the survival rate beyond the neonatal period. Variables considered were those available at 24 h after admission. The overall survival rate was 49%. In the multivariate analysis, significant contributions for the prediction of neonatal survival were provided by four variables: genetic amniocentesis-related cause of PROM (p <0.001), gestational age at PROM (p = 0.019), CRP > 1 mg/dl within 24 h after admission (p = 0.042) and oligohydramnios (largest vertical pocket ≤2 cm) (p = 0.041). The corresponding adjusted odds ratio (OR)s were 73.9 (95% CI: 7.9-694.7), 1.5 (95% CI: 1.1-2.0) per week, 0.26 (95% CI: 0.07-0.95) and 0.20 (95% CI: 0.04-0.93), respectively. Genetic amniocentesis-related cause of PROM, gestational age at PROM, C-reactive protein >1 mg/dl and oligohydramnios are significantly associated with survival in women with periviable PROM. The evaluation of these few and easily available variables may help physicians and patients in the decision-making process of this demanding condition.

Original languageEnglish
Pages (from-to)1628-1634
Number of pages7
JournalJournal of Maternal-Fetal and Neonatal Medicine
Volume26
Issue number16
Publication statusPublished - Nov 2013

ASJC Scopus subject areas

  • Medicine(all)

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