Background: Preterm prelabor rupture of membranes (PPROM) is a frequent obstetrical condition with risks of maternal and neonatal morbidity and mortality. Home hospitalization (HH) management is an alternative to conventional hospitalization (CH) which remains controversial, and there has been little study of eligibility criteria.
Objective: To study obstetrical and perinatal outcomes of PPROM between 24 and 34 gestational weeks in patients discharged to homecare after 4 days, based on a policy of expanded discharge criteria.
Study Design And Setting: Retrospective before-and-after study over 10 years in a single French level III perinatal center. In period A (2009-2013), discharge criteria were restrictive and in period B (2015-2019), more extended discharge criteria were adopted. The primary outcome was the incidence of confirmed early-onset neonatal sepsis (EOS).
Results: The proportion of patients discharged to home hospitalization increased from 28/170 (16.5) in period A to 39/114 (34.2) in period B (p < 0.01). Regarding the primary outcome, no statistically significant difference in EOS rates was observed between periods (11/153 (7.1) vs 5/110 (4.5), p = 0.37). The incidence of a composite outcome combining severe perinatal complications (intrauterine fetal demise, placental abruption and cord prolapse) did not significantly increase during period B (7/170 (4.1) vs 4/114 (2.7), p = 0.37). There was no significant difference between the periods for chorioamniotitis (9.41% in period A and 11.4% in period B, p = 0.58).
Conclusion: Severe maternal or neonatal complications rates did not increase when criteria for home hospitalization were expanded. Larger, prospective studies are needed to confirm the results of such a strategy.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jogoh.2023.102638 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
The Impact of Antibiotics on Latency When Given at the Time of Membrane Rupture Prior to Viability.
Am J Perinatol
January 2025
Obstetrics and Gynecology, Duke University Hospital, Durham, United States.
Background: It is well established that antibiotics administered in preterm prelabor rupture of membranes increases latency to delivery. While data is limited for membrane rupture prior to viability, antibiotics may also increase latency in this population.
Objective: To assesses the effect of prophylactic antibiotics on the duration of latency in individuals with previable prelabor rupture of membranes.
Assessment of the thymus in fetuses prior to spontaneous preterm birth using functional MRI.
Early Hum Dev
January 2025
Department of Women and Children's Health, St Thomas' Hospital, King's College London, London, UK; Department of Perinatal Imaging, St Thomas' Hospital, King's College London, London, UK.
Objectives: The aim of this study was to utilise T2* relaxometry (an indirect method of quantifying tissue oxygenation) to assess the fetal thymus in uncomplicated pregnancies throughout gestation and in a cohort of fetuses that subsequently deliver very preterm.
Methods: A control group of participants with low-risk pregnancies were recruited and retrospectively excluded if they developed any pregnancy related complications after scanning. Participants were recruited who were deemed to be at very high risk of delivery prior to 32 weeks' gestation and retrospectively excluded if they did not deliver prior to this gestation.
Assessing Second Trimester Ferning in Diagnosing Preterm Prelabor Rupture of Membranes.
Am J Perinatol
January 2025
MFM, Albany Medical Center, Albany, United States.
Preterm prelabor rupture of membranes (PPROM) diagnosis is made through visualization of amniotic fluid (pooling), nitrizine testing, sonographic low amniotic fluid, and microscopic detection of amniotic fluid arborization (ferning). Data exits on the specificity and sensitivity of ferning detection but has not focused on the second trimester. Our objective is to evaluate the presence of ferning in transvaginally collected amniotic fluid in pregnancies with known second trimester PPROM to determine if there is a difference in ferning based on gestational age and sample drying time.
View Article and Find Full Text PDFOutcomes of Extremely Preterm Infants Exposed to Prolonged Prelabor Rupture of Membranes before 24 Weeks of Gestation.
Am J Obstet Gynecol
January 2025
Department of Pediatrics, Duke University School of Medicine, Durham, NC.
Background: Preterm prelabor rupture of membranes (PPROM) before or around the limit of fetal viability is associated with serious maternal and neonatal complications including chorioamnionitis, extremely preterm birth, and pulmonary hypoplasia.
Objectives: To describe contemporary outcomes of extremely preterm infants born after prolonged periviable PPROM, and to identify perinatal factors associated with survival and survival without severe neurodevelopmental impairment (NDI).
Study Design: Among actively treated infants born alive at <27 weeks' gestational age (GA) in centers of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network from 2012 to 2018, the outcomes of survival and survival without severe NDI at 22-26 months' corrected age were compared between infants exposed to prolonged (≥120 hours) periviable (<24 weeks' GA) PPROM and unexposed infants born after rupture of membranes ≤18 hours before delivery or at delivery, adjusting for birth GA, sex, multiple gestation, antenatal steroids, small for gestational age (SGA), insurance, and center.
The impact of uterine position on conception modes and perinatal outcomes in nulliparous patients.
Eur J Obstet Gynecol Reprod Biol
February 2025
Department of Obstetrics and Gynecology, Rambam Health Care Campus, Haifa, Israel; Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. Electronic address:
Purpose: Retroverted uterus affects 15-20% of patients. While typically not a cause for concern, some studies suggest a relationship between a retroverted uterus and subfertility. Study objective was to investigate the association between uterine position and spontaneous conception rates, as well as potential risks for adverse pregnancy outcomes in nulliparous patients.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!