Preterm premature rupture of membranes: a randomized study of home versus hospital management.
OBJECTIVE
To compare length of latency period, gestational age at delivery, and safety in a carefully selected group of patients with preterm premature rupture of the membranes (PROM) randomized to home versus hospital management.


METHODS
After meeting strict inclusion criteria, 67 patients with preterm PROM were randomized by sealed envelope to home versus hospital expectant management. The groups were managed similarly with pelvic and bed rest. Management included recording of temperature and pulse every 6 hours, daily charting of fetal movements, twice-weekly nonstress test and complete blood count, and weekly ultrasound and visual examination of the cervix.


RESULTS
There was no significant difference in clinical characteristics or perinatal outcome between the groups. There was, however, a significant decrease in both the days of maternal hospitalization and maternal hospital expenses in the home group.


CONCLUSIONS
Only a very small proportion of cases of preterm PROM (18%) could meet the strict safety criteria for inclusion used in the study. In the home-management group, length of the latency period and gestational age at delivery were not significantly different than in hospitalized patients.
Carlan
S J
SJ
Department of Obstetrics and Gynecology, University of South Florida College of Medicine, Tampa.
O'Brien
W F
WF
Parsons
M T
MT
Lense
J J
JJ
D003365:Costs and Cost Analysis; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000191:economics / Q000628:therapy*; D006699:Home Care Services / Q000191:economics; D006760:Hospitalization / Q000191:economics; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome