[Preliminary clinical study on the management of 26-34 week pregnancy with premature rupture of the membranes (PRM)].

Abstract

Unlabelled: The aim of this study was to determine the optimal solution to the dilemma of "wait-and-see" or "evacuation of uterine contents" and to identify objective criteria in support of one or other of these management choices, in particular in 26-34 week pregnancies with PRM, which is the most difficult situation. On the basis of a clinical study of 54 cases, week pregnancies with PRM did not enable temporization for any considerable time because of the onset of amniotic infection, and a large number of premature newborn with a gestational age of 31-32 weeks, below 1500-1700 g respectively, died a short time after birth.

Conclusions: In 26-34 week pregnancies with PRM, a "wait-and-see" attitude with its sometimes very considerable septic risks is justified by a high chance of fetal survival score (CFSS)--a concept suggested by the authors--, i.e. with a gestational age between 30-34 weeks and respective fetal weights (determined by ultrasonography) between 1400-2100 g, absence of intrauterine fetal pathology, favorable fetal vitality parameters, good prognosis foe vaginal delivery, low C-reactive protein levels, low-grade pathogenicity of cervicovaginal flora, etc. In their preliminary study, the authors suggest determination of a chance of fetal survival score (CFSS) which is of prognostic value and can be useful in determining optimal management in the dilemma raised by PRM in 26-34 week pregnancies.