Preterm premature rupture of membranes ≥ 32 weeks' gestation: impact of revised practice guidelines.

Abstract

OBJECTIVE:

The purpose of this study was to determine the perinatal impact of the 2007 American College of Obstetricians and Gynecologists Practice Bulletin on preterm premature membrane rupture.

STUDY DESIGN:

Perinatal outcomes were compared in women who had experienced preterm membrane rupture in the 3 years before the 2007 Practice Bulletin to similar women who experienced preterm premature rupture of membranes in the 3 years after the issue and implementation of the guideline.

RESULTS:

After adjustment for gestational age at membrane rupture and steroids, composite severe morbidity (death, respiratory distress syndrome, assisted ventilation for ≥ 6 hours, sepsis, pneumonia, grade 3 or 4 intraventricular hemorrhage, or necrotizing enterocolitis) was similar by group. Infants in the "after" group experienced less pneumonia and sepsis, similar respiratory morbidity, but more labor inductions and postpartum hemorrhage.

CONCLUSION:

The new guideline significantly decreases severe neonatal infections but is associated with more frequent labor induction and postpartum hemorrhage.

• Authors: Arij Faksh, Joseph R Wax, F Lee Lucas, Angelina Cartin, Michael G Pinette
• Journal: American journal of obstetrics and gynecology (Am J Obstet Gynecol) Vol. 205 Issue 4 Pg. 340.e1-5 (Oct 2011) ISSN: 1097-6868 [Electronic] United States
• PMID: 21784402 (Publication Type: Journal Article)
• Copyright: Copyright © 2011 Mosby, Inc. All rights reserved.

Topics

• Adult
• Female
• Fetal Membranes, Premature Rupture (therapy)
• Gestational Age
• Guideline Adherence
• Humans
• Practice Guidelines as Topic
• Pregnancy
• Pregnancy Trimester, Third
• Retrospective Studies