DAILY FETAL MOVEMENT AND BREATHING ASSESSMENTS IN THE MANAGEMENT OF PRETERM MEMBRANE RUPTURE

Objective: This study was conducted to determine whether the use of a daily sonographic assessment of fetal movement and breathing in patien ts with preterm premature rupture of membranes would lead to a decreas e in fetal or neonatal infectious morbidity. Methods: A cohort study, using a historical control group, was performed. One hundred twenty-fi ve patients with preterm premature rupture of membranes underwent dail y sonographic assessment of fetal movement and breathing. Abnormal res ults were used as an indication for delivery. The control group consis ted of 99 patients with preterm premature rupture of membranes for who m such daily sonographic assessments had been performed as part of a s tudy protocol, but the results were withheld from the managing physici ans. The incidences of chorioamnionitis and neonatal sepsis between gr oups were compared. Results: Neither the incidence of chorioamnionitis (12 vs 14%) nor the incidence of neonatal sepsis (7 vs 4%) was statis tically different between the study group and the control group. Withi n the study group, those patients delivered solely because of an abnor mal fetal movement and breathing assessment (n = 28) had fetal and neo natal infectious outcomes similar to those of patients delivered for o ther indications (n = 97). Conclusions: The use of a daily sonographic assessment of fetal movement and breathing did not lower the rate of fetal or neonatal infectious morbidity in patients with preterm premat ure rupture of membranes.