Second‐trimester prelabour rupture of membranes (PPROM between 16+0/7 and 24+0/7 weeks of gestation) complicates 0.4–0.7% of all pregnancies and results in high rates of perinatal morbidity and mortality.1–3 Ongoing pregnancies are challenged by lack of amniotic fluid (oligohydramnios), which is crucial for pulmonary development.4,5 Consequently, outcomes of pregnancies complicated by second‐trimester PROM are poor due to high rates of pulmonary hypoplasia, neonatal and maternal infection, and extremely premature delivery.6
1. Williams O, Michel B, Hutchings G, Debauche C, Hubinont C. Two-year neonatal outcome following PPROM prior to 25 weeks with a prolonged period of oligohydramnios. Early Hum Dev 2012;88: 657–61.
2. Nourse CB, Steer PA. Perinatal outcome following conservative management of mid‐trimester pre‐labour rupture of the membranes. J Paediatr Child Health 1997;33:125–30.
3. Mercer BM. Preterm premature rupture of the membranes: current approaches to evaluation and management. Obstet Gynecol Clin North Am 2005;32:411–28.
4. Hibbard JU, Hibbard MC, Ismail M, Arendt E. Pregnancy outcome after expectant management of premature rupture of the membranes in the second trimester. J Reprod Med 1993;38:945–51.
5. Vintzileos AM, Campbell WA, Nochimson DJ, Weinbaum PJ. Degree of oligohydramnios and pregnancy outcome in patients with premature rupture of the membranes. Obstet Gynecol 1985;66:162–7.
6. Kilbride HW, Thibeault DW. Neonatal complications of preterm premature rupture of membranes: Pathophysiology and management. Clin Perinatol 2001;28:761–85.
Published: September 16, 2020Take Course