Neonatal complications of PPROM

NeoNotes Journal Club

Preterm Rupture of Membranes
Editor’s Note: The topic of Preterm Premature Rupture of Membranes (PPROM) was the subject of the Dec 2001 issue of Clinics in Perinatology. Since neonatologists are occasionally called upon to advise obstetricians or counsel families with this condition, I felt that an update on the latest recommendations might be helpful. ABK

Neonatal Complications of PPROM

Kilbride HW and Thibeault, TW. Clinics in Perinatology (Dec 2001); 28:761-85.

Neonatal complications of mid-trimester PPROM include:

Infection - 5-8% risk despite intrapartum antibiotic prophylaxis;

Prematurity - 50% deliver within 1 week of ROM, 75% within 2 weeks.

Contractures and deformations – related to oligohydramnios;

Pulmonary hypoplasia – related to oligohydramnios; incidence 16%; best managed with early surfactant and gentle ventilation;

Persistent Pulmonary Hypertension – may be responsive to inhaled nitric oxide.

Recent advances in perinatal and neonatal care have improved neonatal survival for this condition from 39% in the 1980s to 65% in 1996-2000. Neurodevelopmental outcomes are similar to other VLBW infants.

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