Preterm premature rupture of membranes: is home care acceptable?

Abstract

Background: Preterm prelabor rupture of membranes is a frequent obstetric condition associated with increased risks of maternal and neonatal morbidity and mortality. Conventional management is in hospital. Outpatient management is an alternative in selected cases; however, the safety of home management has not been established.

Objective: To study the obstetric and neonatal outcomes of women with preterm premature rupture of membranes between 24 and 34 weeks who were managed as outpatient (outpatient care group), compared with those managed in hospital (hospital care group).

Study design: A retrospective cohort study between 1 January 2009 and 31 December 2013 in three French tertiary care centers.

Results: Ninety women were included in the outpatient care group and 324 in the hospital care group. In the outpatient care group, the gestational age at membrane rupture was lower, compared to the hospital care group (28.8 (26.6–30.5) vs. 30.3 (27.6–32.1) weeks; p < .01) and the cervical length at admission was higher (31.7 ± 10.4 vs. 24.3 ± 11.8 mm; p < .01). In the outpatient care group, no delivery or major obstetric complication occurred at home.

Conclusion: We observed no major complication related to home care after a period of observation. A randomized study would be necessary to confirm its safety.

Keywords:

• Chorioamnionitis
• home care
• perinatal outcomes
• preterm premature rupture of membranes

Acknowledgements

We warmly thank Geraldine Meunier (Department of Obstetrics and Gynecology, Hôpital Louis Mourier) and Audrey Darnieaud (Department of Obstetrics and Gynecology, Hôpital Bicêtre) for their assistance with the patients’ database.

Disclosure statement

The authors report no conflict of interest.