Preterm premature rupture of membranes : ...
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Article dans une revue scientifique: Article original
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Title :
Preterm premature rupture of membranes : which criteria contraindicate home care management ?
Author(s) :
Petit, Celine [Auteur]
Hôpital Jeanne de Flandre [Lille]
Deruelle, Philippe [Auteur]
Hôpital Jeanne de Flandre [Lille]
Behal, Helene [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Rakza, Thameur [Auteur]
Environnement périnatal et croissance - EA 4489 [EPS]
Balagny, Sara [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Subtil, Damien [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Clouqueur, Elodie [Auteur]
Hôpital Jeanne de Flandre [Lille]
Garabedian, Charles [Auteur]
Environnement périnatal et croissance - EA 4489 [EPS]
Hôpital Jeanne de Flandre [Lille]
Deruelle, Philippe [Auteur]
Hôpital Jeanne de Flandre [Lille]
Behal, Helene [Auteur]

Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Rakza, Thameur [Auteur]

Environnement périnatal et croissance - EA 4489 [EPS]
Balagny, Sara [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Subtil, Damien [Auteur]

Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Clouqueur, Elodie [Auteur]
Hôpital Jeanne de Flandre [Lille]
Garabedian, Charles [Auteur]

Environnement périnatal et croissance - EA 4489 [EPS]
Journal title :
Acta Obstetricia et Gynecologica Scandinavica
Abbreviated title :
Acta Obstet Gynecol Scand
Volume number :
97
Pages :
1499-1507
Publisher :
Wiley Online Library
Publication date :
2018-08-06
ISSN :
1600-0412
English keyword(s) :
preterm premature rupture of membranes (PPROM)
home care
hospitalization
perinatal outcome
home care
hospitalization
perinatal outcome
HAL domain(s) :
Sciences du Vivant [q-bio]
English abstract : [en]
BACKGROUND: Home care management offers a suitable alternative to hospitalization for management of preterm premature rupture of membranes (PPROM). Eligibility criteria have not been clearly established. Our aim was to ...
Show more >BACKGROUND: Home care management offers a suitable alternative to hospitalization for management of preterm premature rupture of membranes (PPROM). Eligibility criteria have not been clearly established. Our aim was to determine predictive factors of complication during home care management of PPROM in order to define optimal eligibility criteria. METHODS: Retrospective cohort study of all women with singleton pregnancies with PPROM managed as outpatients between 2009 and 2015. Complications were defined as the occurrence of one of these events: fetal death, placental abruption, umbilical cord prolapse, delivery outside maternity hospital, neonatal death. RESULTS: In all, 187 women with PPROMs were managed as outpatients, of whom 12 had a complication (6.4%). In the "complication" group, gestational age at diagnosis (P = 0.006) and at delivery (P < 0.001) were lower, with no difference in latency between these two events. Three criteria significantly increased the risk for a severe complication: PPROM occurring before 26 weeks (P = 0.008), non-cephalic fetal presentation (P = 0.02) and oligoamnios (P = 0.02). When unfavorable criteria were associated with PPROM, the risk was increased (1 criterion, odds ratio [OR] 1.6; 2 criteria, OR 6.9 and 3 criteria, OR 32.8). CONCLUSIONS: Combination of these three criteria is an indication for conventional hospitalization to limit maternal and fetal morbidity. When two criteria are combined, home care should be discussed for each case. If only one unfavorable criteria is present, outpatient management is suitable. To validate these results, a prospective randomized study should be conducted.Show less >
Show more >BACKGROUND: Home care management offers a suitable alternative to hospitalization for management of preterm premature rupture of membranes (PPROM). Eligibility criteria have not been clearly established. Our aim was to determine predictive factors of complication during home care management of PPROM in order to define optimal eligibility criteria. METHODS: Retrospective cohort study of all women with singleton pregnancies with PPROM managed as outpatients between 2009 and 2015. Complications were defined as the occurrence of one of these events: fetal death, placental abruption, umbilical cord prolapse, delivery outside maternity hospital, neonatal death. RESULTS: In all, 187 women with PPROMs were managed as outpatients, of whom 12 had a complication (6.4%). In the "complication" group, gestational age at diagnosis (P = 0.006) and at delivery (P < 0.001) were lower, with no difference in latency between these two events. Three criteria significantly increased the risk for a severe complication: PPROM occurring before 26 weeks (P = 0.008), non-cephalic fetal presentation (P = 0.02) and oligoamnios (P = 0.02). When unfavorable criteria were associated with PPROM, the risk was increased (1 criterion, odds ratio [OR] 1.6; 2 criteria, OR 6.9 and 3 criteria, OR 32.8). CONCLUSIONS: Combination of these three criteria is an indication for conventional hospitalization to limit maternal and fetal morbidity. When two criteria are combined, home care should be discussed for each case. If only one unfavorable criteria is present, outpatient management is suitable. To validate these results, a prospective randomized study should be conducted.Show less >
Language :
Anglais
Audience :
Internationale
Popular science :
Non
Administrative institution(s) :
CHU Lille
Université de Lille
Université de Lille
Collections :
Submission date :
2020-02-11T09:07:38Z
2024-04-10T09:47:23Z
2024-04-23T13:16:41Z
2024-04-10T09:47:23Z
2024-04-23T13:16:41Z
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