IMR Press / CEOG / Volume 45 / Issue 3 / DOI: 10.12891/ceog4278.2018

Clinical and Experimental Obstetrics & Gynecology (CEOG) is published by IMR Press from Volume 47 Issue 1 (2020). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with S.O.G.

Original Research
Management and outcomes of preterm premature rupture of the membranes
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1 Department of Clinical Science, Obstetrics & Gynaecology, Sundsvalls Research Unit, Umeå University, Umeå
2 Department of Obstetrics & Gynaecology, Sundsvalls County Hospital, Sundsvall, Sweden
Clin. Exp. Obstet. Gynecol. 2018, 45(3), 419–424; https://doi.org/10.12891/ceog4278.2018
Published: 10 June 2018
Abstract

Purpose of investigation: To compare the maternal and neonatal outcomes of preterm premature rupture of the membranes (PPROM) between two management strategies. Materials and Methods: This retrospective cohort study involved 153 pregnant women who presented with PPROM at a gestational age of 28+0 to 36+6 weeks to evaluate the effects of expectant management (EM; labor > 36 hours) and active management (AM; labor < 36 hours) on maternal and neonatal outcomes. The EM and AM groups were also compared independently of gestational age and after being divided into two subgroups: early PPROM (gestational age 28+0 to 33+6 weeks) and late PPROM (34+0 to 36+6 weeks). Results: There were no differences between the AM and EM groups in the rates of maternal infection or placental abruption, or in neonatal outcomes, including low Apgar scores, respiratory distress syndrome, or the need for continuous positive airway pressure (CPAP). In the early PPROM subgroup, arterial umbilical blood base excess levels were more negative in the AM group (p = 0.007). In the late PPROM subgroup, the change in systolic blood pressure between admission to the maternity care center and membrane rupture was greater in the AM group (p = 0.049). Conclusions: There were no clinically significant differences in the maternal and neonatal outcomes of PPROM between AM and EM.
Keywords
Preterm
Premature
Rupture of membrane
Delivery
Expectant management
Active management
Neonatal and maternal outcomes
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