A comparison of maternal and neonatal outcomes in cases of pre-viable preterm premature rupture of membranes (pPPROM) according to weeks of gestation

Aim: The rupture of the amniotic membrane before 24 weeks gestation is defined as pre-viable preterm premature rupture of membranes (pPPROM). This study aims to compare the maternal and neonatal outcomes of cases of pPPROM detected before and after 22 weeks of gestation. Materials and Methods: This retrospective study evaluated singleton pregnancies with pPPROM between 2014 and 2019. The pPPROM cases were divided into two groups: Group 1 consisted of cases between 12+0 and 21+6 weeks of gestation, while Group 2 consisted of cases between 22+0 and 23+6 weeks of gestation. The obstetric outcomes, maternal complications, and neonatal intensive care unit (NICU) admission rates were compared in both groups. Furthermore, the neonatal outcomes of fetuses with a birth weight of over 500 grams were compared in both groups. Results: A total of 181 cases of pPPROM were identified, with 45 (24.8%) occurring in Group 2. The latent period duration, age at birth, and maternal complications were found to be higher in Group 2 (p < 0.05). Twenty percent of cases resulted in viable outcomes (15/136 vs. 22/45, p < 0.001). In Group 1, higher Apgar scores, lower rates of admission to NICU, and higher rates of pregnancy termination were observed in fetuses with a birth weight of over 500 grams (p < 0.05). Conclusion: In cases of pPPROM after the 22nd week of gestation, although the incidence of maternal morbidity is lower, the rate of admission to NICU is higher in fetuses born weighing over 500 grams.