Planned Outpatient Care versus Hospital Admission for Women with Preterm Prelabor Rupture of the Membranes (PPROM): A Randomized-Controlled Clinical Trial

Abstract Background Preterm premature rupture of membranes (PPROM) is a condition where the amniotic sac ruptures before the onset of labor, occurring in about 3% of pregnancies. It is a leading cause of perinatal morbidity and mortality, resulting in neonatal morbidities such as respiratory distress syndrome, necrotising enterocolitis, and sepsis. Depending on the gestational age, complications such as chorioamnionitis, premature placental abruption, umbilical cord prolapse, and postpartum infections can occur. The clinical course following PPROM depends on the latency period, which is inversely correlated with gestational age and influenced by several factors, including the presence of antepartum hemorrhage and cervical opening. Objective To examine the efficacy and safety of planned outpatient management versus hospital admission for women with preterm prelabor rupture of the membranes (PPROM) in terms of fetal, neonatal, and mother outcomes. Patients and Methods patients were divided into two groups (O) was planned for outpatient care and Group (H) was hospitalized after randomization. The primary outcome was comparing between two groups regarding the latency period and other maternal and neonatal outcomes were recorded. Results Regarding the results of our study, we found that there is no statistically significant difference between the study groups regarding age and parity. No statistically significant difference between the study groups regarding gestational age at enrollment and delivery as well as well as the latency period between them being slightly longer in the outpatient group. As regards the neonatal outcome, the rate of complications was insignificant among both groups, Intra-amniotic infection being slightly higher among hospitalized group, antenatal fetal distress & post-natal fetal respiratory distress syndrome as well. Conclusion PPROM is a serious condition that can result in neonatal morbidities and maternal complications. Expectant management is usually implemented, with hospitalization being the conventional policy recommended until delivery. However, outpatient care may offer a safe and low-cost alternative with a relatively longer latency period. Further studies are needed to confirm the safety of outpatient care in PPROM patients and to address the concerns about potential obstetric emergencies.