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Objective: To examine the influence of vaginal probiotic administration as adjunct to standard antibiotic treatment on perinatal outcome in women with preterm premature rupture of the membranes (PPROM). Materials and methods: This was a prospective randomized trial of cases with PPROM (24-34 weeks) that were admitted to our department between 2011 and 2015. 49 cases received vaginal probiotics for ten days in combination with antibiotic prophylaxis and were compared to 57 others that received only antibiotics for the same time period. Results: The mean gestational age at birth (35.49 weeks vs 32.53 weeks), the mean duration of the latency period (5.60 weeks vs 2.48 weeks) and the mean birth-weight (2,439.08 g vs 2,004.81 g) were significantly higher in the study group in comparison to the controls. Moreover, the neonates of the study group had lower chance to enter the NICU or the Neonatal Special Care Unit, shorter total hospitalization time and lower need for oxygen administration and mechanical ventilation, as well as lower length of oxygen administration. Conclusions: Vaginal probiotics in adjunct to antibiotics prophylaxis in women with PPROM prolonged the latency period and improved the perinatal outcome. [ABSTRACT FROM AUTHOR]