Ruptures before 24 weeks

There are several important variables in PPROM before 24 weeks gestation. First, one must consider their medical diagnoses before PPROM. Many different factors play into PPROM: bleeding or SCH (subchorionic hematoma), infections, BV (bacterial vaginosis), sexually transmitted diseases, inflammatory conditions, incompetent cervix and cerclage placement, etc. Nonetheless, the fact that a woman is diagnosed with PPROM means the treatment of her new condition will be generally the same, regardless of what the cause was. Follow the regimen, monitor for infection, and aim for viability. 

While the statistics of survival vary, we worry most about the Top 3 Concerns of PPROM: pulmonary hypoplasia, extreme premature birth, and chorioamnionitis/sepsis. These issues are very crucial for PPROM pregnancies before 24 weeks. A recent study shows that women who successfully deliver after 24 weeks following prolonged PPROM between 18-24 weeks have a 90% survival rate. Their babies require aggressive management for the Top 3 Concerns, but the survival and long term issues are much lower than previously reported. This report can be found here: Neonatal Survival After Prolonged pProm (see PDF version for full study).

The best indicator of a successful pregnancy is a well-prepared medical team. That begins with a Perinatologist or Maternal-Fetal Medicine Specialist (MFM). This physician is trained in Obstetrics, and has spent an additional three years studying high risk pregnancies through the Society of Maternal Fetal Medicine. They are the most qualified to handle PPROM pregnancies. The MFM has level two ultrasounds in office, and they are qualified to perform surgeries, amniocentesis, and other procedures that a high-risk OB is not able to do.

Pre-Viability PPROM Group on Facebook