Neonatal Survival Rate following Premature Rupture of Membranes at Gestational Age 15-30 Weeks

Objectives: To determine neonatal survival rate and associated factors in pregnancies with preterm premature rupture of membranes (PPROM) at gestational age (GA) between 15 and 30 weeks. Materials and Methods: This retrospective descriptive study was conducted by reviewing the medical records of the pregnant women with premature rupture of membranes (PROM) at 15-30 weeks’ gestation admitted at King Chulalongkorn Memorial Hospital between 1st January 2002 and 31st December 2013. Logistic regression analysis was used to determine association between factors and neonatal survival. Results: The total number of pregnancies in this study was 99 and neonatal survival rate was 80.8% (95% confidence interval 71.4-87.8%). Women with PPROM at GA between 15 and 19+6 weeks had neonatal survival rate of 16.7% while neonatal survival rates of cases with PPROM at 20-23+6 weeks and 24-30 weeks were 50.0% and 92.2%, respectively. Factors associated with increased neonatal survival from logistic regression analysis included GA at PROM ≥ 24 weeks and tocolytic administration. Conclusion: Neonatal survival in pregnancies with midtrimester PPROM depended on GA when PROM started. Neonates in women with PPROM at ≥ 24 weeks’ gestation had more chances to survive than those with PROM at GA less than 24 weeks. Use of tocolysis was associated with increase neonatal survival.