American Journal of Obstetrics & Gynecology
Volume 201, Issue 3 , Pages 230-240, September 2009

The management of preterm premature rupture of the membranes near the limit of fetal viability

Department of Obstetrics and Gynecology, MetroHealth Medical Center, Cleveland, Ohio

Received 20 March 2009; received in revised form 1 May 2009; accepted 23 June 2009.

Preterm premature rupture of the membranes near the limit of fetal viability is an uncommon complication of pregnancy, affecting approximately 4 in 1000 gravidas. However, maternal, fetal, and neonatal complications resulting from this condition are significant and include chorioamnionitis, pulmonary hypoplasia, restriction deformities, fetal loss, and complications of extreme prematurity among surviving infants. In this article, we review the literature regarding pregnancy outcomes after preterm premature rupture of the membranes near the limit of viability, and the data on traditional and nontraditional interventions to improve outcomes. An approach to patients who present with preterm premature rupture of the membranes near the limit of viability will be proposed.

Key words: periviable, preterm premature rupture of membranes, previable

 

 Reprints not available from the authors.

PII: S0002-9378(09)00693-0

doi:10.1016/j.ajog.2009.06.049

American Journal of Obstetrics & Gynecology
Volume 201, Issue 3 , Pages 230-240, September 2009