Poster Session 3
Category: Prematurity
Poster Session 3
Yael Brantz, MD, N/A
OBGYN Resident
Department of Obstetrics and Gynecology, Sheba Medical Center
Ramat gan, HaMerkaz, Israel
Michal Fishel Bartal, MD
Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
Houston, Texas, United States
Michal Axelrod, MD, MPH (she/her/hers)
Sheba Medical Center
Sheba Medical Center, HaMerkaz, Israel
Lital Shaham, MD, PhD (she/her/hers)
Resident Physician, Department of Obstetrics and Gynecology, Sheba Medical Center
Department of Obstetrics and Gynecology, Sheba Medical Center
Sheba Medical Center, HaMerkaz, Israel
Nimrod Dori-Dayan, MD (he/him/his)
Sheba Medical Center
Tel Aviv, Tel Aviv, Israel
In premature preterm rupture of membranes (PPROM) between 24+0 and 31+6 weeks, timing magnesium sulfate for neuroprotection is challenging — too early may result in overtreatment, while too late may miss the therapeutic window. We aimed to identify predictors of delivery within 24 hours to guide timely and targeted use.
Study Design:
We conducted a retrospective cohort study of all individuals with PPROM between 24+0 and 31+6 weeks at a tertiary medical center (2011–2025). Patients were stratified by latency: delivery within ≤24 hours vs. >24 hours. We compared obstetric history, presenting symptoms and outcomes between groups. Multivariable logistic regression was used to determine independent predictors of early delivery.
Results:
Of 463 patients with PPROM, 169 (36.5%) delivered within 24 hours. Independent risk factors for delivery within 24 hours included multifetal pregnancy (46.2% vs. 25.5%, aOR 2.3, 95% CI 1.5–3.5), premature contractions at presentation (35.5% vs. 13.9%, aOR 2.3, 95% CI 1.4–3.9), cervical length < 25mm (13.6% vs. 3.4%, aOR 2.7, 95% CI 1.1–6.3), WBC count >11 K/μL (68.7% vs. 55.5%, aOR 1.6, 95% CI 1-2.4) and gestational age >30 weeks’ gestation (55.6% vs. 32.7%, aOR 2.5, 95% CI 1.6-3.7) (Table). The combined presence of at least three risk factors was associated with 70.3% risk for delivery within 24 hours and yielded a positive likelihood ratio of 4.1 (95% CI 3.6-4.7) (Figure).
Conclusion:
Over one-third of patients with PPROM between 24 and 32 weeks will deliver within 24 hours. Multifetal gestation, short cervix, contractions at presentation, leukocytosis and gestational age > 30 weeks are risk factors that can help identify those at greatest risk. Targeted magnesium use based on these factors may improve outcomes and avoid overtreatment.