Amniocentesis in the management of preterm premature rupture of the membranes: a retrospective cohort analysis.

Objective: This retrospective analysis determined the utility of amniocentesis in the management of preterm premature rupture of the membranes (PPROM).

Methods: Consecutive patients with PPROM were managed with and without amniocentesis. Both groups received antibiotics and corticosteroids; tocolytics were withheld. Patients were induced if clinical or amniotic fluid (AF) proven chorioamnionitis occurred or gestational age goals were reached. Primary endpoints were individual and composite neonatal morbidity (CNM).

Results: One hundred forty-seven maternal patients were managed with amniocentesis (AC) and 146 were managed without amniocentesis (NAC). CNM was significantly reduced in the group managed with AC (OR 2.94, 95% CI 1.68-5.15, NAC vs. AC). NAC patients had similar rates of neonatal sepsis as well as CNM to those patients in the AC group with positive AF Gram stains and/or cultures.

Conclusions: Patients with PPROM who are managed with AC have significantly less CNM than NAC patients.