Outcome of premature infants delivered after prolonged premature rupture of membranes before 25 weeks of gestation

Abstract Objective: To identify factors influencing the outcome of premature infants delivered after prolonged premature rupture of membranes before 25 weeks’ gestation. Design and population: All premature infants with gestational age Results: A total of 28 neonates fulfilled the inclusion criteria. Despite new strategies of ventilation and optimal management, the overall mortality rate was 43% (12/28). Nonsurvivors were significantly less mature at rupture of membranes, and had severe oligohydramnios (anamnios). We also noted less antenatal corticosteroids and antibiotic therapy in this group. Nine of eleven infants (82%) following rupture of membranes before 22 weeks’ gestation died shortly after birth. The two remaining infants developed severe bronchopulmonary dysplasia. Nine deaths occurred in thirteen cases (69%) of anamnios. The major death causes were refractory respiratory failure and neurologic complications. Half of all survivors (8/16) developed bronchopulmonary dysplasia. Conclusion: The outcome of premature infants following prolonged premature rupture of membranes before 25 weeks’ gestation is influenced by gestational age at rupture, severity of oligohydramnios, and antenatal antibiotics and corticosteroids. Neonates with rupture of membranes before 22 weeks have a very low chance of survival at the present time.