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Is homecare management associated with longer latency in preterm premature rupture of membranes?

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

According to national guidelines, conventional management of preterm premature rupture of membranes (PPROM) is hospitalization until induction. Outpatient management could be another option. Our objective was to compare latency period between patients managed in hospital versus outpatients.

Methods

A retrospective before/after monocentric study that occured from 2002 to 2015. Were included all patients with PPROM prior to 35 weeks with homecare inclusion criteria. The primary outcome measure was to study length of latency period (delay between PPROM and delivery). Second outcome measures were maternal and perinatal morbidities and mortalities.

Results

Among the 395 women included after PPROM, 191 were managed as outpatients and 204 in hospital. In the outpatient group, the length of latency period was longer than in the inpatient group [39 (IQR 20 to 66) versus 21 (IQR 13 to 42) days; p < 0.001]. Clinical chorioamnionitis was observed in 30 (15.7%) in outpatient group versus 49 (24.0%) in inpatient group (p = 0.039). Concerning neonatal outcome, there were less neonatal transfer (49.2% versus 77.2%, p < 0.001), less respiratory distress syndrome (29.4% versus 47.5%; p < 0.001), less neonatal sepsis (13.9% versus 22.1%; p = 0.037), less bronchodysplasia (2.7% versus 9.8%; p = 0.004), and less pulmonary arterial hypertension (4.8% versus 10.3%; p = 0.040) in the outpatient group than in the inpatient group.

Conclusion

Home management seems to be a safe option to hospitalization in selected patients with PPROM. However, a randomized study would be required to approve those results.

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Abbreviations

PPROM:

Preterm premature rupture of membranes

IQR:

Interquartile range

IUFD:

Intrauterine Fetal Death

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Funding

The authors received no specific funding for this work. This study was approved by the French National Commission on Informatics and Liberty (reference DEC16- 210) on the date of the 14/07/2017. The Ethical Committee “Comité d’éthique de la recherche en obstétrique et en gynécologie” has examined the research with the date from 2002 to 2012, and was found to conform generally accepted scientific principles and medical research ethical standards.

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Authors and Affiliations

  1. Department of Obstetrics, CHU Lille, Avenue Eugène Avinée, 59000, Lille, France

    M. Guckert, E. Clouqueur, C. Petit, V. Houfflin-Debarge, D. Subtil & C. Garabedian

  2. Department of Biostatistics, Univ. Lille, CHU Lille, EA 2694—Public Health Epidemiology and Healthcare Quality, 59000, Lille, France

    E. Drumez

  3. University of Lille, EA 4489—Perinatal Environment and Health, 59000, Lille, France

    V. Houfflin-Debarge & C. Garabedian

Authors
  1. M. Guckert
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  2. E. Clouqueur
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  3. E. Drumez
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  4. C. Petit
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  5. V. Houfflin-Debarge
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  6. D. Subtil
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  7. C. Garabedian
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Correspondence to M. Guckert.

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Informed consent was obtained from all individual participants included in the study.

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Guckert, M., Clouqueur, E., Drumez, E. et al. Is homecare management associated with longer latency in preterm premature rupture of membranes?. Arch Gynecol Obstet 301, 61–67 (2020). https://doi.org/10.1007/s00404-019-05363-x

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  • DOI: https://doi.org/10.1007/s00404-019-05363-x

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