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Management of Preterm Premature Rupture of Membranes in the Late Preterm Period.

Publication ,  Journal Article
Freeman, SW; Denoble, A; Kuller, JA; Ellestad, S; Dotters-Katz, S
Published in: Obstet Gynecol Surv
May 2022

IMPORTANCE: For patients who present with prelabor rupture of membrane (PROM) in the late preterm period (34 to 36 6/7 weeks), management remains unclear due to lack of consensus. However, recent guidelines have suggested that shared decision-making may be used and expectant management can be considered up to 37 0/7 weeks. OBJECTIVE: In this article, we review the contemporary studies comparing the risks and benefits of immediate delivery versus expectant management for patients with late preterm prelabor rupture of membranes (PPROM). EVIDENCE ACQUISITION: Original research articles, review articles, and guidelines on management of late PPROM. RESULTS: Three randomized clinical trials and 2 meta-analyses comparing expectant management and immediate delivery outcomes in late PPROM showed no significant difference in neonatal sepsis rates between groups. Expectant management increased the likelihood that pregnancies reached term while decreasing the rate of cesarean delivery. However, data suggest an increased risk of antepartum hemorrhage among patients in the expectant management groups, as well as higher rates of histologic chorioamnionitis. CONCLUSIONS AND RELEVANCE: We recommend that clinicians offer expectant management as an alternative to immediate delivery in the setting of late PPROM through a shared decision-making process that clearly outlines the risks and benefits.

Duke Scholars

Published In

Obstet Gynecol Surv

DOI

EISSN

1533-9866

Publication Date

May 2022

Volume

77

Issue

5

Start / End Page

283 / 292

Location

United States

Related Subject Headings

  • Premature Birth
  • Pregnancy Outcome
  • Pregnancy
  • Obstetrics & Reproductive Medicine
  • Infant, Newborn
  • Humans
  • Gestational Age
  • Fetal Membranes, Premature Rupture
  • Female
  • Cesarean Section
 

Citation

APA
Chicago
ICMJE
MLA
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Freeman, S. W., Denoble, A., Kuller, J. A., Ellestad, S., & Dotters-Katz, S. (2022). Management of Preterm Premature Rupture of Membranes in the Late Preterm Period. Obstet Gynecol Surv, 77(5), 283–292. https://doi.org/10.1097/OGX.0000000000001024
Freeman, Sarah W., Annalies Denoble, Jeffrey A. Kuller, Sarah Ellestad, and Sarah Dotters-Katz. “Management of Preterm Premature Rupture of Membranes in the Late Preterm Period.Obstet Gynecol Surv 77, no. 5 (May 2022): 283–92. https://doi.org/10.1097/OGX.0000000000001024.
Freeman SW, Denoble A, Kuller JA, Ellestad S, Dotters-Katz S. Management of Preterm Premature Rupture of Membranes in the Late Preterm Period. Obstet Gynecol Surv. 2022 May;77(5):283–92.
Freeman, Sarah W., et al. “Management of Preterm Premature Rupture of Membranes in the Late Preterm Period.Obstet Gynecol Surv, vol. 77, no. 5, May 2022, pp. 283–92. Pubmed, doi:10.1097/OGX.0000000000001024.
Freeman SW, Denoble A, Kuller JA, Ellestad S, Dotters-Katz S. Management of Preterm Premature Rupture of Membranes in the Late Preterm Period. Obstet Gynecol Surv. 2022 May;77(5):283–292.

Published In

Obstet Gynecol Surv

DOI

EISSN

1533-9866

Publication Date

May 2022

Volume

77

Issue

5

Start / End Page

283 / 292

Location

United States

Related Subject Headings

  • Premature Birth
  • Pregnancy Outcome
  • Pregnancy
  • Obstetrics & Reproductive Medicine
  • Infant, Newborn
  • Humans
  • Gestational Age
  • Fetal Membranes, Premature Rupture
  • Female
  • Cesarean Section