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Is homecare management associated with longer latency in preterm premature rupture of membranes?
Guckert, M; Clouqueur, E; Drumez, E; Petit, C; Houfflin-Debarge, V; Subtil, D; Garabedian, C.
Afiliación
  • Guckert M; Department of Obstetrics, CHU Lille, Avenue Eugène Avinée, 59000, Lille, France. guckert.marion@gmail.com.
  • Clouqueur E; Department of Obstetrics, CHU Lille, Avenue Eugène Avinée, 59000, Lille, France.
  • Drumez E; Department of Biostatistics, Univ. Lille, CHU Lille, EA 2694-Public Health Epidemiology and Healthcare Quality, 59000, Lille, France.
  • Petit C; Department of Obstetrics, CHU Lille, Avenue Eugène Avinée, 59000, Lille, France.
  • Houfflin-Debarge V; Department of Obstetrics, CHU Lille, Avenue Eugène Avinée, 59000, Lille, France.
  • Subtil D; University of Lille, EA 4489-Perinatal Environment and Health, 59000, Lille, France.
  • Garabedian C; Department of Obstetrics, CHU Lille, Avenue Eugène Avinée, 59000, Lille, France.
Arch Gynecol Obstet ; 301(1): 61-67, 2020 01.
Article en En | MEDLINE | ID: mdl-31760462
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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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Rotura Prematura de Membranas Fetales / Atención Dirigida al Paciente Tipo de estudio: Guideline / Observational_studies / Risk_factors_studies Límite: Adult / Female / Humans / Newborn / Pregnancy Idioma: En Revista: Arch Gynecol Obstet Asunto de la revista: GINECOLOGIA / OBSTETRICIA Año: 2020 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Alemania
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Rotura Prematura de Membranas Fetales / Atención Dirigida al Paciente Tipo de estudio: Guideline / Observational_studies / Risk_factors_studies Límite: Adult / Female / Humans / Newborn / Pregnancy Idioma: En Revista: Arch Gynecol Obstet Asunto de la revista: GINECOLOGIA / OBSTETRICIA Año: 2020 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Alemania