Denver, Colo. ― 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.
The abstract was published in the January 2025 issue of Pregnancy, a new open-access journal and the first official journal for the Society for Maternal-Fetal Medicine.
Additional news releases about select SMFM research being presented are posted on AAAS’s EurekAlert (subscription needed).
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About the Society for Maternal-Fetal Medicine
The Society for Maternal-Fetal Medicine (SMFM), founded in 1977, is the medical professional society for obstetricians who have additional training in high-risk, complicated pregnancies. SMFM represents more than 7,000 members who care for high-risk pregnant people and provides education, promotes research, and engages in advocacy to reduce disparities and optimize the health of high-risk pregnant people and their families. SMFM and its members are dedicated to optimizing maternal and fetal outcomes and assuring medically appropriate treatment options are available to all patients. For more information, visit SMFM.org and connect with the organization on Facebook, X, and Instagram. For the latest 2025 Annual Meeting news and updates, follow the hashtag #SMFM25.