Factors associated with a latency < 7 days after preterm premature rupture of membranes between 22 and 32 weeks of gestation in singleton pregnancies - 02/07/21

Doi : 10.1016/j.jogoh.2021.102194

Charlotte Benedetti, MD ^a, Diane Korb, MD ^b,^c, Julie Rotureau, MS ^c, Jacques Lepercq, MD ^a,^⁎
^a Port-Royal Maternity Unit, Cochin Hospital, APHP, Paris, France
^b Department of Obstetrics and Gynecology, Robert Debré Hospital, APHP, Paris, France
^c Université de Paris, Epidemiology and Statistics Research Center/CRESS, INSERM, INRA, Paris, France

^⁎Corresponding author Jacques Lepercq, MD Maternité Port Royal 123, boulevard de Port-Royal 75014 Paris, France Tel: + 33 1 58 41 38 71; Fax: + 33 1 58 41 38 01Maternité Port Royal123, boulevard de Port-RoyalParis75014France

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Highlights

•	In women with premature rupture of membranes, the latency phase between rupture and delivery is difficult to predict.
•	Women with uterine contractions and cervical length at admission < 20 mm are at highest risk of delivery within 7 days (rate: 91%).
•	Uterine contractions and shortened cervix at admission could make home care reconsidered in women with PPROM.

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Abstract

Objective

To identify factors at admission associated with a latency < 7 days after Preterm premature rupture of membranes (PPROM) between 22 and 32 weeks of gestation in singleton pregnancies.

Material and methods

A retrospective comparative study of all women with singleton pregnancies admitted for PPROM to an academic tertiary center during the 5-year period of 2015-2019. Women who gave birth < 7 days and ≥ 7 day after PPROM were compared. We determined risk at admission associated with a latency < 7 days after PPROM by logistic regression and identified high-risk subgroups by classification and regression tree (CART) analysis.

Results

Among 174 eligible births, 76 (44%) women gave birth < 7 days after PPROM and 98 (56%) later. The two groups had similar maternal baseline and obstetric characteristics. In multivariate analysis, the following variables reported at admission were independently associated with a latency < 7 days: painful uterine contractions (aOR 3.9, 95%CI 1.1-7.4), cervical length < 20 mm (aOR 2.4, 95%CI 1.2-4.8), and C reactive protein ≥ 10 mg/L (aOR 2.4, 95% CI 1.3-4.8). Women with painful uterine contractions and cervical length at admission < 20 mm were at highest risk of latency < 7 days (rate: 91%). Conversely, the women at lowest risk were those without uterine contractions, with a cervical length ≥ 20 mm, and C-reactive protein < 10 mg/L at admission (rate: 22%).