Poster Session 2
Category: Genetics
Poster Session 2
Hila Shalev Ram, MD, N/A
Department of Obstetrics and Gynecology Meir Medical Center
Kfar Saba, HaMerkaz, Israel
Yael Shalev-Rosenthal, MD, MPH (she/her/hers)
'Rabin medical center'
Rabin medical center/ Petach tikwa, HaMerkaz, Israel
Yael Wolf, MD
Faculty of Medical and Health Sciences, Tel Aviv University
Kfar Saba, HaMerkaz, Israel
Maya Finkelstein
Department of Obstetrics and Gynecology, Lis Maternity Hospital, Sourasky Medical Center, Tel Aviv, Israel
Tel Aviv, Tel Aviv, Israel
Ron Schonman, MD
Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel
Kfar Saba, Tel Aviv, Israel
Zvi Klein
Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel
Kfar Saba, HaMerkaz, Israel
Eran Hadar
Helen Schneider Hospital for Women, Rabin Medical Center, Petach-Tikva, Israel
Petach Tikva, HaMerkaz, Israel
Yariv Yogev, MD
Lis Hospital for Women’s Health, Tel Aviv Sourasky Medical Center Gray Faculty of Medicine, Tel Aviv University, Israel
Lis Hospital for Women’s Health, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
Michal Kovo, PhD
Chair
Shamir Medical Center
Beer Yaacov, HaMerkaz, Israel
Shai Ram, MD
Ichilov Tel Aviv Israel
ichilov, HaMerkaz, Israel
Tal Biron-Shental, MD (she/her/hers)
Chair OBGYN, MFM
Meir Medical Center
Kfar Saba, HaMerkaz, Israel
P-PROM after mid-trimester amniocentesis (AC) is rare but clinically important. Although it is generally thought to have a more favorable course than spontaneous P-PROM at similar gestational ages, data are limited to small series, and actual prognosis remains uncertain. We aimed to determine pregnancy outcomes and prognostic factors for a live fetus after mid-trimester AC complicated by P-PROM .
Study Design:
Retrospective cohort in three university tertiary centers (2014-2025). Exclusions: multifetal gestation, elective terminations of pregnancy due to genetic abnormalities, clinical chorioamnionitis at admission. Cases were stratified as live vs. no live birth (termination of pregnancy [TOP] or late abortion [< =22 weeks]). Multivariable logistic regression tested predictors of live birth.
Results:
The final cohort included 93 women:
o Late abortion in 4 women (4.3 %; mean latency between AC to abortion 1.05 ± 0.77 wk).
o TOP for adverse findings in 38 women (40.9 %; latency between AC to TOP 3.08 ± 2.57 wk): oligohydramnios 24 (63 %), continuous leak 6 (15.8 %), chorioamnionitis 2 (5.3 %), contractions 2 (5.3 %), and single cases (2.6 % each) of pulmonary hypoplasia, placental abruption, IUFD, or unknown indication.
o Overall live births rate was: 51 / 93 (54.8 %). Of them, 37 (72.5 %) at ≥ 37 wk and 13 (25.5 %) prior to 37 wk, of them , 7 [7.5%] < 34 wk, 4 [4.3%] < 32 wk, 1 [1.1%] < 28 wk. Both women with continuous leakage delivered preterm at 32.0 wk and 30.5 wk.
In multivariable analysis, AFI >5 cm at admission was the only independent predictor for live birth (OR 19.5; 95% CI 4.2–90.2; p< 0.001). Latency from AC to PPROM, IVF, BMI >30, maternal age, parity, previous abortions, and placental location were not significant.
Conclusion:
Approximately half of women presenting with P-PROM after mid-trimester amniocentesis had a live birth. Most non-viable outcomes were iatrogenic (TOP for adverse clinical status). AFI >5 cm at admission was the strongest predictor of favorable outcome.