Short-Term and Long-Term Postnatal Outcomes of Expectant Management After Previable Preterm Premature Rupture of Membranes With and Without Persistent XXXX .

@entity1 @entity295 @entity649 @entity245 @entity2107 @entity2906 @entity989 @entity4942 @entity1779 @entity306
OBJECTIVE: To compare postnatal outcomes in pregnancies managed expectantly after previable preterm @entity4942 ( @entity4942 ) in relation to amniotic fluid volume. METHODS: A retrospective cohort study was performed in 92 @entity1 with amniotic fluid leakage for more than a week after previable preterm @entity4942 (gestational age 14 1/7-24 0/7 weeks) who delivered a liveborn neonate at or after 24 1/7 weeks of gestation from 2002 to 2014. Short-term ( @entity295 , @entity1779 , @entity989 , @entity649 , @entity2107 ) and long-term ( @entity306 and @entity245 ) outcomes were compared between @entity1 with (n=58) and without persistent @entity2906 (n=34), defined as maximal vertical pocket less than 2 cm or amniotic fluid index less than 5 cm. We analyzed discrete data using the    or Fisher's exact test and continuous variables using Student's t test or Mann-Whitney U test. We also performed multivariable analyses. RESULTS: There was a significant difference in survival rate at discharge (44/58 [75.9%] compared with 34/34 [100%], P=.001) and @entity245 at a median age of 4 years after performing multiple regression analysis (adjusted odds ratio [OR] 70.3, 95% confidence interval [CI] 2.9-1,719.9, P=.009) between @entity1 with persistent @entity2906 and @entity1 with normal amniotic fluid volume. A multiple regression analysis, performed to control for confounders, revealed that gestational age at delivery (adjusted OR 0.3, 95% CI 0.1-0.7, P=.008) and breech presentation (adjusted OR 90.8, 95% CI 2.2-3,778.1, P=.018) were significant factors affecting survival of @entity1 with persistent @entity2906 . CONCLUSION: The postnatal survival rate after previable preterm @entity4942 was lower and @entity245 more frequent in @entity1 with persistent @entity2906 than in @entity1 with normal amniotic fluid volume. Even so, most neonates born alive after previable preterm @entity4942 and persistent @entity2906 survived to discharge and were developmentally normal. The overall survival rate was higher than in previous studies. LEVEL OF EVIDENCE: II.
