What we discovered during the PPROM study, and how we will use the information to develop more effective treatment and guidance.
2 in 3 women continued their pregnancy and 1 in 3 women had Termination For Medical Reasons (TFMR)
Amongst women who chose to continue their pregnancy 39% gave birth in the week after PPROM.
This means that a lot of babies were born too early to survive or very premature.
Amongst women who chose to continue their pregnancy 44% had a baby that was born alive.
If we include the women who had TFMR within the results the worst-case scenario is that 30% of babies may be born alive, and the best-case scenario is 62%.
The chance of the baby being born alive was better when the waters broke slightly later in pregnancy.
When the waters broke at 16-17 weeks of pregnancy 33% of women who chose to continue with pregnancy had a baby that was born alive.
The worst-case scenario for women whose waters broke at 16-17 weeks is 17% and the best-case is 65%. This range is so wide because 45% of women with PPROM at this stage of pregnancy had TFMR.
When the waters broke in the 22nd week of pregnancy 67% of women had a baby born alive.
The worst-case scenario for all women with PPROM at 22 weeks was 54% and the best-case scenario was 73%.
The chance of the baby leaving hospital alive was 26% amongst women who chose to continue with pregnancy.
If we include the women who had TFMR; the worst-case scenario is 17% and the best case is 53% of babies leave hospital alive.
The chance of the baby leaving hospital alive was better if the pregnancy was more advanced when the baby was born.
The chance of the baby leaving hospital alive without severe illness was 18% amongst women who chose to continue with pregnancy.
If we include the women who had TFMR; the worst-case scenario is 12% and the best-case scenario is 48% of women, who may have left the hospital with a surviving baby, without serious illness.
The chance of the baby leaving hospital alive without severe illness was better if the pregnancy was more advanced when the baby was born.
Of the babies born alive; 39% left hospital without severe illness,16% left hospital with severe illness, 29% died, and 16% did not have follow up data.
There was a lot of variation in how long surviving babies stayed in hospital. The average length of hospital stay was 2 months, but 1 in 4 babies stayed in hospital less than 17 days and 1 in 4 babies stayed more than 3 months.
Twins had similar outcomes to the pregnancies with just one baby, especially if each twin had its own placenta and own sac (these are called dichorionic diamniotic pregnancies, DCDA).
Overall the change of a woman with PPROM developing sepsis was 14%
The chance of admission to the intensive care was 1.1% in mothers
There were two women with early PPROM in this study who died, both due to sepsis. This gives a chance of maternal death of 0.5%.
We had fewer pregnancies reported per month during the period of the COVID-19 pandemic than before the COVID-19 pandemic.
We did not find a significant difference in mother or baby outcomes according to whether the PPROM occurred before or during the pandemic.
