Inpatient Versus Outpatient Management of Preterm Prelabour Rupture of Membrane. A Prospective Cohort Study

Document Type : Original Article

Authors

1 Department of Obstetrics & Gynecology - Faculty of Medicine – Ain Shams University –Cairo – Egypt

2 Department of Obstetrics & Gynecology – Bolak Eldakror General Hospital – Ministry of Health – Cairo - Egypt

3 Department of Obstetrics & Gynecology – Faculty of Medicine – Ain Shams University –Cairo – Egypt

Abstract

Objective: To assess the effectiveness and safety of the outpatient management approach for patients with preterm prelabour rupture of membrane regarding the latency period, incidence of chorioamnionitis, and neonatal outcomes.   
Patients and Methods: This prospective cohort study included 63 Patients with confirmed diagnosis of PPROM. All included patients were admitted to the inpatient ward for 48 hours where they received IV antibiotics and corticosteroids for fetal lung maturation then, 31 patients were managed as outpatient and 32 patients were managed as inpatient. The primary outcome was the latency period and gestational age at birth while the incidence of chorioamnionitis, and neonatal outcomes in terms of neonatal weight, neonatal intensive care (NICU) admission, and neonatal sepsis were secondary measures of outcome.    
Results: The latency period (days) was significantly longer (29.4±15.8 vs 17.7±11.9, p 0.002) and the gestational age (weeks) at birth was significantly higher (35.0±1.8 vs 33.6±1.9, p 0.004) among the outpatient arm. There was no significant difference between the two arms regarding the incidence of chorioamnionitis, neonatal weight, NICU admission and neonatal sepsis.
Conclusion: Outpatient management of patients with PPROM is safe approach which can be adopted particularly in low risk patients. 

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