ABSTRACT
The purpose of this study was to evaluate the outcome of patients with preterm premature rupture of membranes (PPROM) managed as inpatients who would have been candidates for outpatient management by prior published criteria. A retrospective review of medical records of PPROM subjects enrolled in a prospective cohort study was performed. Similar criteria to those established in a randomized trial for home management of PPROM by Carlan et al were applied. Assuming local residence, 65 subjects met the criteria for outpatient management. Demographic and delivery information were collected. Of the 65 subjects, 12 (18%) delivered < 2 hours from the sentinel event. Adverse outcomes in these 12 subjects could have been devastating had they been managed as outpatients. Given the susceptibility of these subjects to obstetric emergencies, patients with PPROM at a viable gestational age should be considered for management as inpatients in a tertiary-care facility.
KEYWORDS
Preterm premature rupture of membranes - outpatient - inpatient - management
REFERENCES
-
1
Goldenberg R L.
The management of preterm labor.
Obstet Gynecol.
2002;
100(5 Pt 1)
1020-1037
-
2
Besinger R E.
Preterm labor, premature rupture of membranes, and cervical incompetence.
Curr Opin Obstet Gynecol.
1993;
5(1)
33-39
-
3
ACOG Practice Bulletin. Clinical management guidelines for obstetrician-gynecologists.
Obstet Gynecol.
2003;
101(5)
1039-1047
-
4
Mercer B M.
Preterm premature rupture of the membranes.
Obstet Gynecol.
2003;
101(1)
178-193
-
5
Alexander J M, Cox S M.
Clinical course of premature rupture of the membranes.
Semin Perinatol.
1996;
20(5)
369-374
-
6
Hack M, Taylor H G, Klein N, Eiben R, Schatschneider C, Mercuri-Minich N.
School-age outcomes in children with birth weights under 750 g. [see comment].
N Engl J Med.
1994;
331(12)
753-759
-
7
Carlan S J, O'Brien W F, Parsons M T, Lense J J.
Preterm premature rupture of membranes: a randomized study of home versus hospital management.
Obstet Gynecol.
1993;
81(1)
61-64
-
8
Magann E F, Nolan T, Hess L, Martin R, Whitworth N, Morrison J.
Measurement of amniotic fluid volume: accuracy of ultrasonography techniques.
Am J Obstet Gynecol.
1992;
167(6)
1533-1537
-
9
Ramsey P S, Nuthalapaty F S, Lu G, Ramin S, Nuthalapaty E S, Ramin K D.
Contemporary management of preterm premature rupture of membranes (PPROM): a survey of maternal-fetal medicine providers.
Am J Obstet Gynecol.
2004;
191(4)
1497-1502
-
10 Cunningham F, McDonald P, Gant N. Williams Obstetrics. Norwalk, Conn; Appleton & Lange 1989
-
11
Bartfield M C, Carlan S J.
The home management of preterm premature ruptured membranes.
Clin Obstet Gynecol.
1998;
41(3)
503-514
-
12
Martin D, Gardner M, Howell K, Griffin M, Gonzalez J, Curet L.
Outcome and cost analysis of preterm premature rupture of membranes in an outpatient setting.
Am J Obstet Gynecol.
1996;
174
463
Sarah C EllestadM.D.
Duke University Medical Center, Department of Obstetrics and Gynecology, Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Box 3967
Durham, NC 27710; reprints not available from the author
