Noncephalic fetuses in the setting of preterm premature rupture of membranes (PROM) are at greater risk of neonatal death than cephalic fetuses, even after controlling for gestational age and route of delivery, a recent study found. The secondary analysis included 1,767 women, 439 (24.5%) had a noncephalic presentation, and randomized to receive magnesium sulfate compared with placebo in the previously reported Maternal-Fetal Medicine Units Network Beneficial Effects of Antenatal Magnesium Sulfate (1997-2004) trial. Women with a singleton gestation and preterm PROM were included. Researchers found:
• Noncephalic presentation was associated with an earlier median gestational age at the time of preterm PROM (26.6 vs 28.4 weeks of gestation), but no difference in gestational latency.
• No differences in odds of abruption or neonatal morbidity were observed.
• However, odds of neonatal death before discharge were greater for noncephalic gestations, even after controlling for potential confounding factors.
Yee LM, Grobman WA. Perinatal outcomes in cephalic compared with noncephalic singleton presentation in the setting of preterm premature rupture of membranes before 32 weeks of gestation. [Published online ahead of print September 5, 2016]. Obstet Gynecol. doi:10.1097/AOG.0000000000001614.