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Murillo, Clara; Ferrero, Silvia; Cobo, Teresa; Renau, Montse Izquierdo; Aldecoa, Victoria; Grau, Laia; Ponce, Julia; Rueda, Claudia; Palacio, Montse
International journal of gynecology and obstetrics, August 2023, 2023-Aug, 2023-08-00, 20230801, Letnik: 162, Številka: 2Journal Article
Objective To evaluate the maternal, fetal, and neonatal outcomes of pregnant women complicated with preterm prelabor rupture of membranes (PPROM) eligible for outpatient care. Methods This study included a retrospective cohort of patients with singleton pregnancies with PPROM between 23+0 to 34+0 weeks who remained pregnant after the first 72 h. Outpatient management was considered in women with clinical, ultrasound and analytical stability, and easy access to hospital. Maternal, fetal, and neonatal results were compared between women managed as inpatients versus those managed as outpatients. Results Women eligible for the outpatient management had a better prognostic profile (no anhydramnios, longer cervical length, less intraamniotic infection, and clinical, ultrasound, and analytical stability) and presented a lower gestational age at admission and longer latency to delivery, resulting in a similar gestational age at delivery as the inpatient group. Postpartum curettage, uterine atony, respiratory distress syndrome, and bronchopulmonary dysplasia were less frequent in the outpatient group. Composite maternal‐fetal morbidity and mortality outcomes were similar in both groups, while composite neonatal morbidity and mortality outcomes were significantly lower in the outpatient group. Conclusion Outpatient management may be an option for women presenting stable PPROM before 34 weeks when adequate selection criteria are fulfilled. Differences in perinatal outcomes in the outpatient group compared with the inpatient group are probably attributable to baseline characteristics. Further prospective randomized studies are needed to confirm the benefits of outpatient management in PPROM. Synopsis Home care may be an option for managing stable preterm prelabor rupture of membranes before 34 weeks when accurate selection criteria are fulfilled.
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JCR | SNIP | JCR | SNIP | JCR | SNIP | JCR | SNIP |
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