New study finds increased maternal complications with previable premature rupture of membranes
Previable premature rupture of membranes (PROM) is when the amniotic sac, the protective membrane that surrounds the fetus, ruptures before 22 weeks of gestation. When it occurs so early in pregnancy, it poses a serious health risk to the mother and baby. Options include termination of the pregnancy, or expectant management with close maternal monitoring.
In a new study presented today at the Society for Maternal-Fetal Medicine’s (SMFM) annual meeting, The Pregnancy Meeting™ researchers reported findings that suggest that for pregnant women who develop previable PROM, the risk of being admitted to the Intensive Care Unit, needing a blood transfusion, and/or developing sepsis increased significantly after implementation of Texas Senate Bill 8 (SB8). SB8, which went into effect on Sept. 1, 2021, bans abortion after a fetal heartbeat is detected unless there is a “medical emergency.”
In the five-year retrospective study (2018-2023), researchers compared the outcomes of pregnant women with previable PROM before and after the law went into effect. Before Sept. 1, 2021, approximately one-half chose to terminate the pregnancy due to previable PROM as the sole indication. After SB8, termination for previable PROM was not an option unless there was a diagnosis of a “medical emergency.” After the law went into effect, the risk of serious adverse outcomes, including sepsis, significantly increased from 24 percent to 38.5 percent. The rates of sepsis also increased after SB8 from 9.4 percent to 29.2 percent. There was also a non-statistically significant trend for increased neonatal survival from 2.5 percent to 8.3 percent.
Based on their results and evidence from prior studies, the investigators conclude that given the increased maternal health risks, professional societies and state medical boards should clarify whether previable PROM alone is a medical indication for pregnancy termination.
Reference:
New study finds increased maternal complications with previable premature rupture of membranes, Society for Maternal-Fetal Medicine, Meeting:2025 Pregnancy Meeting