Maternal- Fetal and Neonatal Outcome in 26-32 Weeks Pregnancies with Preterm Premature Rupture of Membranes (PPROM): a Comparison between Inpatient and Outpatient Management

Premature Rupture of Membranes (PROM) occurring before 37 weeks of gestation is referred to as Preterm Premature Rupture of Membranes (PPROM). This study was aimed to identify whether home caring of mothers، while they are under tight medical control، has any serious side effects on mother and fetus or not?

Patients with 26-32 weeks of gestational who complicated with PPROM were hospitalized for seven days and were treated with antibiotics and Betamethasone. Then patients were divided into two groups. “Group-I” were sent to home (Outpatient) and observation was continued and “Group-II” were hospitalized till the end of their pregnancy (Inpatient). All patients in Group-I were also hospitalized again at the beginning of the 32nd week and if it was possible، all pregnancies were ended on the 34th week.

The time interval between PPROM and delivery، prevalence of child hospitalization in neonatal unit، and intra-ventricular hemorrhage (IVH) were lesser in inpatient group. The rate of cesarean، need for ventilatory support، the period of child hospitalization in neonatal unit، prevalence and hospitalization period in NICU، and neonatal mortality were higher in inpatient group. The rate of metritis، chorioamnionitis، one and five minutes’ Apgar scores، premature placenta detachment، average of umbilical arteries base excess (BE) and pH، and the last biophysical profile (BPP) score were similar in both groups.

For patients who are well trained to know the risky symptoms and have immediate access to the hospitals and medical care centers، if they has a amniotic fluid index (AFI) more than 5cm، and the period between their PPROM and 34th week of their pregnancy is so long، they can be followed through the protocol in their homes.