Maternal Morbidity following Periviable Prelabor Rupture of Membranes after Texas Senate Bill 8.
Objective: Standard practice prior to Texas Senate Bill 8 (SB 8) for those with periviable prelabor rupture of membranes (PROM) without contraindications to expectant management was to offer termination of pregnancy or expectant management. After SB 8 went into effect, pregnancy termination was only...
| Publicado en: | American Journal of Perinatology Vol. 43; no. 7; pp. 949 - 955 |
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| Autores principales: | , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Thieme Medical Publishing Inc.
May2026
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=193262070&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 193262070 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 07351631 GQK jtl: American Journal of Perinatology issn: 07351631 maglogo: N pubinfo: dt: May2026 vid: 43 iid: 7 pid: 2811 pub: Thieme Medical Publishing Inc. place: New York, New York artinfo: ui: 193262070 193262070 193262070 10.1055/a-2712-5549 193262070 ppf: 949 ppct: 6 formats: tig: atl: Maternal Morbidity following Periviable Prelabor Rupture of Membranes after Texas Senate Bill 8. aug: au: Ghafir, Danna Fahl, Emily Ukoh, Nancy Chen, Han-Yang Blackwell, Sean C. Gutierrez, Julie Stafford, Irene A. affil: McGovern Medical School at UTHealth, Houston, Texas, United States sug: subj: Comorbidity Fetal Membranes, Premature Rupture Pregnancy Outcomes Maternal-Child Health Health Policy Legislation and Jurisprudence Pregnancy Complications Abortion, Induced Legislation and Jurisprudence Human Texas Female Adult Middle Age Retrospective Design Record Review Prospective Studies Tertiary Health Care Texas Descriptive Statistics Data Analysis Software Multivariate Analysis Multiple Regression Chi Square Test Fisher's Exact Test Wilcoxon Rank Sum Test Kruskal-Wallis Test Poisson Distribution Pregnancy Sepsis Confidence Intervals Shock, Septic Postpartum Hemorrhage Abruptio Placentae Length of Stay Amniotic Fluid Pathology Chorioamnionitis Fetal Well-Being Adult: 19-44 years Middle Aged: 45-64 years Female ab: Objective: Standard practice prior to Texas Senate Bill 8 (SB 8) for those with periviable prelabor rupture of membranes (PROM) without contraindications to expectant management was to offer termination of pregnancy or expectant management. After SB 8 went into effect, pregnancy termination was only offered for these patients after the development of chorioamnionitis or clinically significant maternal hemorrhage. The aim of this study was to compare maternal outcomes of periviable PROM before and after SB 8 in Houston, TX. Study Design: This retrospective cohort study compared outcomes of periviable PROM less than 22 weeks of gestational age before and after SB 8 at three tertiary care hospitals from January 1, 2018, to March 31, 2023. Our primary outcome was a composite of adverse maternal outcomes: Sepsis, transfusion, and intensive care unit (ICU) admission. Secondary outcomes included intraamniotic infection, postpartum hemorrhage, abruption, septic shock, hospital length of stay, time from rupture of membranes to delivery, and neonatal survival. Results: Over the 5-year study period, 161 women met the inclusion criteria (96 pre-SB 8 vs. 65 post-SB8). Approximately half (54%) of those with periviable PROM opted for termination prior to SB8. Post-SB8, women were more likely to develop an adverse outcome (22.9 vs. 35.4%; aRR = 1.69, 95% confidence interval [CI]: 1.03–2.78), and were more likely to develop sepsis (9.4 vs. 29.2%; adjusted relative risk [aRR] = 2.97, 95% CI: 1.43–6.17). Five neonates survived to hospital discharge post-SB8, and one survived prior to SB8. Additionally, those expectantly managed post-SB8, compared with those expectantly managed pre-SB8, experienced a longer time from rupture of membranes to delivery (6.5 days post [2–14] vs. 3 days pre [1–7.5]), and a higher rate of sepsis (18 post [30.0%] vs. 6 pre [15.0%]). Conclusion: These results provide evidence that periviable PROM alone is a life-threatening condition with a serious risk of maternal harm. Waiting for maternal infection or hemorrhage to develop before offering pregnancy termination increases the risks of serious maternal morbidity. Key Points: Pre-SB8, 54% of women with periviable PROM chose termination. Increased rates of sepsis were observed post-SB8. Longer rupture of membranes to delivery times were observed post-SB8. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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