What question did this study set out to answer?

The study aims to evaluate the obstetric outcomes and neonatal survival associated with preterm prelabor rupture of membranes.

April 11, 2026Open Access

Outcomes and latency to delivery in preterm prelabour rupture of membranes at 22 + 0 to 28 + 0 weeks: a retrospective cohort study

Key Points

The study aims to evaluate the obstetric outcomes and neonatal survival associated with preterm prelabor rupture of membranes.
Conducted a retrospective cohort analysis involving 167 pregnancies with PPROM at 22 + 0 to 28 + 0 weeks.
Divided pregnancies into three gestational age groups for analysis.
Examined latency to delivery and neonatal survival to discharge and without major morbidity.
Analyzed outcomes based on gestational age at PPROM and subsequent delivery logistics.
Median latency to delivery was 6 days with no significant difference between gestational age groups.
Neonatal survival to discharge was 67% among liveborn infants.
Survival without major morbidity at 12 months was 42.9% for liveborn infants.
Higher survival rates were observed in PPROM cases diagnosed at 26 + 0 to 28 + 0 weeks.

Abstract

Preterm prelabor rupture of membranes (PPROM) is a major obstetric complication associated with substantial adverse perinatal outcomes. Large-cohort analyses are essential to reduce uncertainty in gestational-age–specific management and to support evidence-based counselling. This retrospective cohort study was conducted at SBÜ Zeynep Kamil Women’s and Children’s Diseases Training and Research Hospital (January 2018 and February 2023) and included 167 pregnancies with PPROM between 22 + 0 to 28 + 0 weeks’ gestation. While obstetric outcomes were analyzed for the entire cohort(n = 167), neonatal survival analyses were limited to 91 liveborn infants managed exclusively at our institution; 66 neonates were transferred to external centers post-stabilization.The decision to transfer was driven solely by logistical constraints related to neonatal intensive care unit (NICU) bed capacity at the time of delivery. Pregnancies were stratified into three groups by gestational age at PPROM (22 + 0 to 23 + 6, 24 + 0 to 25 + 6 and 26 + 0 to 28 + 0 weeks). Primary outcomes consisted of obstetric outcomes, including latency to delivery, along with neonatal survival to discharge and survival without major morbidity at 12 months of corrected age. The median latency to delivery was 6 days (IQR, 2–23) and did not differ significantly between the groups (median range 5–9 days; P = 0.942). Obstetric and postpartum outcomes were similar across groups. Neonatal survival to discharge was 67.0% (61/91) and survival without major morbidity at 12 months of corrected age was 42.9% (39/91) among liveborn infants. Both outcomes were highest when PPROM was diagnosed at 26 + 0 to 28 + 0 weeks (P < 0.001 and P = 0.007, respectively). In PPROM occurring between 22 + 0 and 28 + 0 weeks, the median latency to delivery remained independent of gestational age. While GA at PPROM remains the primary determinant of outcomes, longer latency was associated with more favorable survival. These findings provide a concrete framework for clinical management and individualized counseling in very early PPROM. Not applicable.

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