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Poster Session 1

Category: Prematurity

Poster Session 1

(330) Clinical interventions and pregnancy outcomes in pregnancies following periviable rupture of membranes

Wednesday, February 11, 2026

10:30 AM - 12:00 PM

Submitting Author and Presenting Author(s)

Rebecca Crowe, MD

Maternal Fetal Medicine Fellow
Medical University of South Carolina
Charleston, South Carolina, United States

Coauthor(s)

JY

Julia Yerger

Medical Student
Medical University of South Carolina
Charleston, South Carolina, United States
JP

Jessica Pittman, MD

Resident Physician
Medical University of South Carolina
Charleston, South Carolina, United States
Eliza R. McElwee, MD

Maternal Fetal Medicine Fellowship Program Director
Medical University of South Carolina
The Medical Univeristy of South Carolina, South Carolina, United States

Objective:
The aim of this study was to characterize antenatal interventions and associated pregnancy outcomes in immediate subsequent pregnancies following a pregnancy affected by pre- and peri-viable rupture of membranes (pPROM).

Study Design:
This is a retrospective cohort study of immediate subsequent pregnancies following a pregnancy affected by pPROM from 2005-2024. We included patients with a prior pregnancy affected by pPROM at < 25 weeks gestation and subsequent prenatal care and delivery at our institution. Subsequent pregnancy antenatal interventions and outcomes were evaluated and stratified by recurrent preterm birth (PTB). Chi Square was used for categorical variables and Kruskall Wallis as appropriate was used to compare continuous variables with significance at p < 0.05. A logistic regression was used to generate adjusted odds ratios (aOR) for the primary outcome of recurrent preterm birth.

Results:
A total of 75 p</span>atients had a history of pPROM with subsequent pregnancy outcomes available for review during the study period. Of these, 64% (n=48) had a subsequent term delivery and 36% (n=27) had subsequent PTB. 72% (n=54) had sonographic cervical length (CL) assessment and/or cerclage in subsequent pregnancies. When comparing subsequent term and PTB, there was no difference in cerclage frequency between groups (54.4 v 53.9%, p= 0.96). Patients with cervical shortening requiring urgent cerclage had increased rates of PTB (63%), compared to patients with a normal CL (30.8%) or those who underwent history indicated cerclage (25.9%), p=0.04. There was no difference in odds of PTB in patients undergoing a history indicated cerclage compared to a referent group of patients with a normal CL (OR 0.79, 95% CI 0.18 - 3.39).

Conclusion:
Patients with a history indicated cerclage or a normal cervical length had similar rates of PTB following a pregnancy with pPROM < 25w. The highest rates of PTB are in patients with cervical shortening prompting urgent cerclage. History indicated cerclage does not appear to cause harm and may provide benefit in p</span>atients with a history of pPROM.