Implications for the future

The key outcomes are now being used to develop resources for women, families and doctors to use at the time of early PPROM. These will help all those involved to make informed decisions about the pregnancy after early PPROM.

These findings highlight the complexity of pregnancies with very early PPROM. We now have figures showing clearly that some babies and mothers have very good outcomes, but also some babies and mothers get very ill or even lose their lives to this condition.

In order to improve outcomes for future women with very early PPROM the research team suggests that two strategies are needed, in parallel. One strategy is to work out how best to organise care for women after early PPROM with current available treatments, and ensure that appropriate support, counselling and education are offered. The other strategy is to develop new interventions. Now that we know the baseline outcomes for mums and babies these studies can be planned.

This study shows that there is a lot of uncertainty about outcomes of pregnancies with early PPROM and understanding the optimal time to deliver the baby, balancing both mother’s and baby’s health. The patient support and advocacy group, Little Heartbeats, has worked closely with the study team throughout this project. Little Heartbeats highlight that behind the uncertainty about physical health after very early PPROM, many women and their partners will be struggling with their psychological health. Future work should also focus on how best to psychologically support families through these difficult pregnancies.