Scientific opinion of FIGO in the Constitutional Court case of Andrea Prudente against the Maltese state
- Doctors for Choice
- Jun 12
- 2 min read
Dated: 01.02.2023
On behalf of the International Federation of Gynecology and Obstetrics, I would like to submit our scientific opinion in the Constitutional Court case of Andrea Prudente against the Maltese state.
We present this letter in light of the medical facts surrounding the case of Andrea Prudente, who was 15 weeks pregnant when she presented with ruptured membranes and no amniotic fluid. We hereby testify that scientific research shows that the probability of survival of a 15-week-old foetus is far less than the risk of sepsis and haemorrhage of the woman.
We would like to highlight the results of one recent study conducted in Ireland,1 which at the time had a jurisdiction, like that currently in Malta, where termination of pregnancy in the absence of maternal compromise was unavailable. When preterm previable premature rupture of membranes (PPROM) occurred at less than 17 weeks (n=11), none of the infants survived. In this same study, 5 of the 42 women (12%) with PPROM developed clinical chorioamnionitis and one developed sepsis. 18 women (42%) suffered from haemorrhage soon after the rupture of membranes. Also, five women (12%) had haemorrhage after delivery of the foetus, three (7%) of whom needed a blood transfusion.
In a review of 14 studies of women with PPROM below 24 weeks, 37% developed
chorioamnionitis, 10% had a retained placenta, 18.5% had an abruption, and 0.8% had sepsis.2 These can be life-threatening medical situations. Although no maternal deaths were reported in these small studies, case reports from Ireland,3 Italy4 and Poland5 show that the expectant (wait-and-see) management of PPROM can be fatal, very rapidly.
Sincerely
Dr Jeanne Conry
President
1 Linehan et al. Neonatal and maternal outcomes following midtrimester preterm premature rupture of the membranes: a
retrospective cohort study. BMC Pregnancy and Childbirth. 2016. https://doi.org/10.1186/s12884-016-0813-3
2 Waters T, Mercer BM. The management of preterm premature rupture of the membranes near the limit of fetal viability.
AJOG. 201 (3), 230-240, 2009. https://doi.org/10.1016/j.ajog.2009.06.049 and
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