Pregnancy outcome of preterm premature rupture of the membranes before 28 weeks.

From January 1987 to December 1990 at Chang Gung Memorial Hospital, the fetal membrane ruptured in 47 singleton pregnancies at the 20th to the 28th gestational weeks. Sixty-six percent of the patients delivered within three days and 91.5% within one week. Only six (12.8%) patients carried their pregnancies over the 28th week. Of the 47 patients, 16 (34.0%) developed clinical evidence of chorioamnionitis during the latent period. The development of chorioamnionitis was not related to any of clinical factors [gestational age at rupture of the membranes, duration of rupture of the membranes before admission, positive endocervical culture, tocolysis, latent period or the presence of oligohydramnios (p > 0.05)]. The neonatal survival rate was 12.7% (six out of 47). Neonatal death was mainly attributable to prematurity. Gestational age beyond the 28th week and body weight greater than 1000 gm are two factors contributing to fetal survival. When fetal lung maturity has not occurred expectant management in the absence of infection is an alternative treatment.