Marion Rouzaire1, Marion Corvaisier1, Virginie Roumeau2, Aurélien Mulliez3, Feras Sendy1, Amélie Delabaere1, Denis Gallot1,4. 1. Obstetrics and Gynaecology Department, Clermont-Ferrand University Hospital, 63000 Clermont-Ferrand, France. 2. Obstetrics and Gynaecology Department, Emile Roux Hospital, 12 boulevard du Dr Chantemesse, 43012 Le Puy-en-Velay, France. 3. Biostatistics Unit (DRCI) Clermont-Ferrand University Hospital, 63000 Clermont-Ferrand, France. 4. "Translational Approach to Epithelial Injury and Repair" Team, Auvergne University, CNRS, Inserm, GReD, 63000 Clermont-Ferrand, France.
Abstract
BACKGROUND: Preterm premature rupture of membranes (PPROM) is a complication responsible for a third of preterm births. Clinical management is initially hospital based, but homecare management is possible if patients are clinically stable 48 h after PPROM. This study set out to determine factors that are predictive of short latency (delivery ≤ 7 days) exceeding 48 h after PPROM, enabling estimation of the prevalence of maternal and neonatal complications and comparison of maternal and fetal outcomes between inpatient and outpatient management. METHOD: This was a monocentric retrospective study conducted between 1 January 2010 and 28 February 2017 on all patients experiencing PPROM at 24 to 34 weeks + 6 days and who gave birth after 48 h. Maternal, obstetric, fetal, and neonatal variables were included in the data collected. The primary endpoint was latency, defined as the number of days between rupture of membranes and delivery. RESULTS: 170 consecutive patients were analyzed. Short latency could be predicted by the need for tocolysis, a cervical length less than 25 mm at admission and the existence of anamnios. Outpatient follow-up was not found to lead to increased maternal morbidity or neonatal mortality. CONCLUSION: Our study highlights predictive factors of short latency exceeding 48 h after PPROM. Knowledge of these factors may provide justification for outpatient monitoring of patients presenting with a long cervix, absence of need for tocolysis and persistence of amniotic fluid and, thus, no risk factors after 48 h of admission.
BACKGROUND:Preterm premature rupture of membranes (PPROM) is a complication responsible for a third of preterm births. Clinical management is initially hospital based, but homecare management is possible if patients are clinically stable 48 h after PPROM. This study set out to determine factors that are predictive of short latency (delivery ≤ 7 days) exceeding 48 h after PPROM, enabling estimation of the prevalence of maternal and neonatal complications and comparison of maternal and fetal outcomes between inpatient and outpatient management. METHOD: This was a monocentric retrospective study conducted between 1 January 2010 and 28 February 2017 on all patients experiencing PPROM at 24 to 34 weeks + 6 days and who gave birth after 48 h. Maternal, obstetric, fetal, and neonatal variables were included in the data collected. The primary endpoint was latency, defined as the number of days between rupture of membranes and delivery. RESULTS: 170 consecutive patients were analyzed. Short latency could be predicted by the need for tocolysis, a cervical length less than 25 mm at admission and the existence of anamnios. Outpatient follow-up was not found to lead to increased maternal morbidity or neonatal mortality. CONCLUSION: Our study highlights predictive factors of short latency exceeding 48 h after PPROM. Knowledge of these factors may provide justification for outpatient monitoring of patients presenting with a long cervix, absence of need for tocolysis and persistence of amniotic fluid and, thus, no risk factors after 48 h of admission.
Entities:
Keywords:
latency; outpatient; predictive factors; preterm premature rupture of membranes
Authors: Shuwei Zhou; Lingwei Mei; Wei Zhou; Yajun Yang; Xiaoyan Zhang; Xiaoling Mu; Quan Quan; Lan Wang Journal: Front Med (Lausanne) Date: 2022-03-04