Does prolonged preterm premature rupture of the membranes predispose to abruptio placentae?

The association between prolonged preterm premature rupture of the membranes and abruptio placentae was investigated in a case-control study. The incidence of abruptio placentae among 143 women with singleton pregnancies at less than 34 weeks' gestation who had ruptured membranes for at least 24 hours was 5.6%, significantly higher than the 1.4% observed among 143 randomly selected controls without preterm rupture of the membranes (P less than .05). Among patients with prolonged preterm premature rupture of the membranes, those who experienced vaginal bleeding before the onset of labor had a significantly higher risk for abruptio placentae than women who did not bleed (24 versus 2.5%; P less than .001). Regardless of the mechanism by which this association is produced, the clinician should be aware of this potential complication, especially in patients who have recurrent bleeding episodes during the period of expectant management.