- H Gynecology 175675–681. Winn, M Chen, E Amon
there were six neonatal deaths due to pulmonary hypoplasia within the first 24 h of life. Severe oligohydramnios is also an independent predictive factor of pulmonary hypoplasia (Winn et al. 2000) and neonatal death (Kilbride et al. 1996). Chorioamnionitis and placental abruption are potential complications that can affect both maternal and fetal well-being. Because of the poor prognosis, it is not uncommon for parents that have found themselves in this unfortunate situation to opt for termination of pregnancy. However, in the decision-making process, other factors such as cultural, religious, past obstetric history or history of subfertility may influence the parental decision in favour of expectant management. In the presented case, the parents opted for expectant management despite the poor prognostic factors – most notably significant oligohydramnios. Although the latency period was 17 weeks, there was no evidence of pulmonary hypoplasia during the immediate neonatal period. Follow-up at 4 and 8 months showed normal development and growth with no major impairment. We acknowledge that this case represents the minority of cases with PPROM prior to viability; nevertheless it demonstrates that there is a definite possibility of uncomplicated neonatal survival even in the presence of poor prognostic factors.