Outcomes in cephalic vs noncephalic presentation in the setting of preterm premature rupture of membranes.

Abstract

This study was conducted to determine whether fetal position at the time of preterm premature rupture of membranes (PPROM) diagnosis affects outcomes. A retrospective study was designed to assess differences in outcomes between cephalic and noncephalic presentation at PPROM diagnosis between 24 and 34 weeks' gestation. Five hundred sixty-six cases of PPROM were identified; 108 cases (19.1%) were noncephalic at time of PPROM diagnosis. The 2 groups were similar with regard to demographics. Although membrane rupture and delivery occurred earlier in the noncephalic group, there was no difference in latency between groups (cephalic group, 6.22 days vs noncephalic group, 7.85 days; P = .07). Noncephalic pregnancies were substantially more likely to be complicated by oligohydramnios, abruption, intrauterine fetal death, and infectious morbidity. Noncephalic presentation at the time of diagnosis of PPROM independently and significantly increases the risk of maternal complications in such affected pregnancies.