{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T00:37:34Z","timestamp":1779323854614,"version":"3.51.4"},"reference-count":24,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2022,10,7]],"date-time":"2022-10-07T00:00:00Z","timestamp":1665100800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Pre\u2010viable premature rupture of membranes (pre\u2010viable PROM) is a rare event occurring in less than 1% of pregnancies. Nevertheless, it can be responsible for severe maternal complications, the risk of which needs to be balanced with the possibility to prolong the pregnancy up to viable gestational age. Maternal sepsis was reported in 1%\u20135% of women who received conservative management and prophylactic antibiotics, but information on maternal mortality is lacking. Our objective was to identify maternal deaths in women who had pre\u2010viable PROM, describe the characteristics of the women, explore preventability factors within the care they received, and estimate the lethality of pre\u2010viable PROM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>We identified all maternal deaths associated with pre\u2010viable PROM from the 2001\u20132015 French National Confidential Enquiry into Maternal Deaths (NCMM). Data on women's characteristics and the care they received were extracted from the ENCMM database. The lethality was determined after estimating the total number of pregnant women with pre\u2010viable PROM from the national hospital discharge database.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Between 2001 and 2015, we identified seven maternal deaths associated with pre\u2010viable PROM, representing 0.6% of all maternal deaths over this period (ie, maternal mortality ratio 0.06\/100\u2009000 live births). Six maternal deaths were attributed to sepsis after genital infection by Gram\u2010negative bacilli and one to postpartum hemorrhage due to placenta accreta. Four of these seven cases were considered preventable. The main preventability factors were delayed diagnosis, delayed fetal extraction, and inappropriate antibiotic treatment. The estimated lethality was 4.5\/10\u2009000 women with pre\u2010viable PROM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Maternal death associated with pre\u2010viable PROM is rare but possible. Most of these deaths seem preventable, with areas for improvement related to earlier diagnosis and better treatment of uterine infections, which can evolve rapidly.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.14452","type":"journal-article","created":{"date-parts":[[2022,10,8]],"date-time":"2022-10-08T05:42:13Z","timestamp":1665207733000},"page":"1395-1402","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Maternal mortality in women with pre\u2010viable premature rupture of membranes: An analysis from the French confidential enquiry into maternal deaths"],"prefix":"10.1111","volume":"101","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3057-6890","authenticated-orcid":false,"given":"Ylann","family":"Abrahami","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Groupe Hospitalier Saint\u2010Joseph  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monica","family":"Saucedo","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris Cit\u00e9, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOP\u00e9, INSERM, INRA  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agn\u00e8s","family":"Rigouzzo","sequence":"additional","affiliation":[{"name":"DREAM, Department of Anesthesiology and Intensive Care Armand Trousseau University Hospital, Assistance Publique\u2010H\u00f4pitaux de Paris  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6561-3321","authenticated-orcid":false,"given":"Catherine","family":"Deneux\u2010Tharaux","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris Cit\u00e9, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOP\u00e9, INSERM, INRA  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elie","family":"Azria","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Groupe Hospitalier Saint\u2010Joseph  Paris France"},{"name":"Universit\u00e9 Paris Cit\u00e9, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOP\u00e9, INSERM, INRA  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"ENCMM group","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,10,7]]},"reference":[{"key":"e_1_2_12_2_1","first-page":"659","article-title":"Preterm premature rupture of membranes: diagnosis and management","volume":"73","author":"Medina T","year":"2006","journal-title":"Am Fam Physician"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2009.06.049"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-011-2179-0"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2014.05.030"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1515\/jpm-2016-0183"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000001530"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(88)80092-9"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2011.03097.x"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0968-8080(13)41711-1"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31829fc38c"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gofs.2020.11.005"},{"key":"e_1_2_12_13_1","first-page":"9","article-title":"Maternal mortality in France: better understanding for more effective prevention","volume":"49","author":"Deneux\u2010Tharaux C","year":"2021","journal-title":"Gynecol Obstet Fertil Senol"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2011.03265.x"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2019.02.021"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000003668"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.15803"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1055\/a-0903-2735"},{"key":"e_1_2_12_19_1","unstructured":"Institut national de la statistique et des \u00e9tudes \u00e9conomiques (INSEE).https:\/\/www.insee.fr\/fr\/statistiques\/2381380#tableau\u2010figure1."},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-016-0813-3"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.12892"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.resmic.2017.02.002"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkaa022"},{"key":"e_1_2_12_24_1","first-page":"994","article-title":"Preterm premature rupture of membranes: CNGOF guidelines for clinical practice","volume":"46","author":"Kayem G","year":"2018","journal-title":"Gynecol Obstet Fertil Senol"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000000330"}],"container-title":["Acta Obstetricia et Gynecologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.14452","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/aogs.14452","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.14452","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T16:19:04Z","timestamp":1741796344000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/aogs.14452"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,7]]},"references-count":24,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2022,12]]}},"alternative-id":["10.1111\/aogs.14452"],"URL":"https:\/\/doi.org\/10.1111\/aogs.14452","archive":["Portico"],"relation":{},"ISSN":["0001-6349","1600-0412"],"issn-type":[{"value":"0001-6349","type":"print"},{"value":"1600-0412","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,7]]},"assertion":[{"value":"2022-05-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-08-25","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-10-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}