Perinatal outcomes following immediate delivery or expectant management of preterm premature rupture of membranes during the late preterm period

Abstract The aim of this study is to evaluate maternal and neonatal outcomes following immediate delivery or expectant management of preterm premature rupture of membranes (PPROM) during the late preterm period at 34+ 0–36+ 6 weeks of pregnancy. We conducted a retrospective study on singleton pregnancies with PPROM during the late preterm period using medical records at twelve tertiary medical centres in Korea from January 2007 to December 2016. Data on demographic characteristics and outcome measures were collected. The primary outcomes were maternal sepsis for maternal outcome and neonatal sepsis and neonatal death for neonatal outcomes. Of the 1,072 women, 782 cases (72.9%) were assigned to the immediate delivery group, and 290 cases (27.1%) were categorized into the expectant management group. There was a significant difference in the rate of clinical neonatal sepsis (immediate delivery, 3.8% vs expectant management, 15.8%; p < 0.0001), however, no differences in maternal sepsis (p = 0.5424), culture-proven neonatal sepsis (p = 0.2108), or neonatal death (p = 0.3899) were observed. In conclusion, expectant management in women with PPROM during the late preterm period does not increase the risk of severe maternal and neonatal morbidities and mortality; however, careful monitoring for chorioamnionitis or fetal compromise should be considered during expectant management.