Expectant management of preterm premature rupture of membranes and nonvertex presentation: what are the risks?

Lewis, David F., Robichaux, Alfred G., Jaekle, Ronald K., Salas, Amber, Canzoneri, Bernard J., Horton, Kelly, Jaekle, Lauren and Stedman, Charles (2007). Expectant management of preterm premature rupture of membranes and nonvertex presentation: what are the risks?. In: American Journal of Obstetrics and Gynecology. 73rd Annual Meeting of the Central Association of Obstetricians and Gynecologists, Las Vegas, NV, United States, (566-567). 18-21 October 2006. doi:10.1016/j.ajog.2007.02.023


Author Lewis, David F.
Robichaux, Alfred G.
Jaekle, Ronald K.
Salas, Amber
Canzoneri, Bernard J.
Horton, Kelly
Jaekle, Lauren
Stedman, Charles
Title of paper Expectant management of preterm premature rupture of membranes and nonvertex presentation: what are the risks?
Conference name 73rd Annual Meeting of the Central Association of Obstetricians and Gynecologists
Conference location Las Vegas, NV, United States
Conference dates 18-21 October 2006
Proceedings title American Journal of Obstetrics and Gynecology   Check publisher's open access policy
Journal name American Journal of Obstetrics and Gynecology   Check publisher's open access policy
Place of Publication Philadelphia, PA, United States
Publisher Mosby
Publication Year 2007
Sub-type Fully published paper
DOI 10.1016/j.ajog.2007.02.023
ISSN 0002-9378
1097-6868
Volume 196
Issue 6
Start page 566
End page 567
Total pages 1
Language eng
Formatted Abstract/Summary
Objective

Preterm premature rupture of membranes (PPROM) continues to be a major cause of preterm births. The objective of this study was to compare the morbidity of patients with PPROM nonvertex presentations with patients with PPROM with vertex presentations.

Study Design

A retrospective analysis of data from 74 patients with PPROM with nonvertex presentations (study group) and 74 patients with PPROM with vertex presentations (control group) comprised the 2 study groups. All patients that met the study admission criteria were treated in a similar manner at 1 of 3 level-III hospitals. The gestational ages at delivery of all patients were between 23-34 weeks, and the gestational ages between case and control patients were matched for gestational age.

Results

A statistically significant (P = .03) higher incidence of a prolapsed umbilical cord was found in the study group (n = 8; 10.8%) relative to the control group (n = 1; 1.4%). More infants in the study group had low 5-minute Apgar scores (<5) and/or low cord pH (<7.20; n = 25 [33.8%]) than in the control group (n = 12 [16.2%]; P = .02). Five infants with breech presentations underwent a precipitous unplanned vaginal delivery. Significant morbidity was not detected in these 5 infants.

Conclusion

After transfer to an antenatal ward, patients with PPROM with nonvertex presentations appear to have a significantly higher risk for prolapsed umbilical cords, lower Apgar scores, and/or lower umbilical cord blood pH values, when compared with their vertex counterparts. Additionally, there appears to be substantial risk of an unintended, vaginal breech delivery.
Q-Index Code E1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Conference Paper
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Created: Mon, 14 Mar 2011, 09:59:32 EST