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Outcomes in cephalic vs noncephalic presentation in the setting of preterm premature rupture of membranes

  • Jean Ricci Goodman
    Correspondence
    Reprints: Jean Ricci Goodman, Loyola University Medical Center, Department of Obstetrics and Gynecology, 2160 S First Ave., Maywood, IL 60153
    Affiliations
    Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, and the Department of Biostatistics and Epidemiology, University of Oklahoma School of Public Health, Oklahoma City, OK
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  • Amy E. Lambert
    Affiliations
    Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, and the Department of Biostatistics and Epidemiology, University of Oklahoma School of Public Health, Oklahoma City, OK
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  • Jennifer David Peck
    Affiliations
    Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, and the Department of Biostatistics and Epidemiology, University of Oklahoma School of Public Health, Oklahoma City, OK
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  • Katie M. Sutton
    Affiliations
    Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, and the Department of Biostatistics and Epidemiology, University of Oklahoma School of Public Health, Oklahoma City, OK
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  • David R. Deschamps
    Affiliations
    Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, and the Department of Biostatistics and Epidemiology, University of Oklahoma School of Public Health, Oklahoma City, OK
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Published:December 10, 2012DOI:https://doi.org/10.1016/j.ajog.2012.12.012

      Objective

      This study was conducted to determine whether fetal position at the time of preterm premature rupture of membranes (PPROM) diagnosis affects outcomes.

      Study Design

      A retrospective study was designed to assess differences in outcomes between cephalic and noncephalic presentation at PPROM diagnosis between 24 and 34 weeks' gestation.

      Results

      Five hundred sixty-six cases of PPROM were identified; 108 cases (19.1%) were noncephalic at time of PPROM diagnosis. The 2 groups were similar with regard to demographics. Although membrane rupture and delivery occurred earlier in the noncephalic group, there was no difference in latency between groups (cephalic group, 6.22 days vs noncephalic group, 7.85 days; P = .07). Noncephalic pregnancies were substantially more likely to be complicated by oligohydramnios, abruption, intrauterine fetal death, and infectious morbidity.

      Conclusion

      Noncephalic presentation at the time of diagnosis of PPROM independently and significantly increases the risk of maternal complications in such affected pregnancies.

      Key words

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