Preterm prelabour rupture of the membranes: a survey of current practice.
BACKGROUND
Preterm prelabour rupture of the membranes (PPROM) complicates 1-2% of all pregnancies. Risks of remaining in utero need to be balanced against the risks of iatrogenic prematurity if early birth is planned.


OBJECTIVE
To assess and further define the current management of women with pregnancies complicated with PPROM in Australia.


METHODS
A mail out questionnaire was sent to all Australian Members and Fellows of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG).


RESULTS
There were 731 responses from RANZCOG Fellows and Members. Corticosteroids were used routinely in the setting of PPROM by 99% (95% confidence intervals (CI) 98.4-100.0%) of obstetricians. Tocolysis was used commonly by 75% (95% CI 98.4-100.0%). Antibiotics are also used routinely by 63% (95% CI 58.8-67.3%) of Australian obstetricians. For women presenting with PPROM less than 34 weeks' gestation 56% (95% CI 48.1-60.0%) of obstetricians would plan to deliver these women prior to term, while for women presenting with PPROM greater than 34 weeks' gestation 50% (95% CI 46.0-54.8%) would offer delivery to such women prior to term.


CONCLUSIONS
There is significant variation in clinical practice in the management of women who present with PPROM in Australia. There is little consensus regarding the optimal timing of delivery for babies of women with pregnancies complicated with PPROM. The present survey supports the need and feasibility of a randomised controlled trial to assess the appropriate gestation at which to deliver women with PPROM near to term.
Buchanan
Sarah
S
Department of Obstetrics and Gynaecology, The University of Sydney, Royal North Shore Hospital, St Leonards, New South Wales, Australia.
Crowther
Caroline
C
Morris
Jonathan
J
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001315:Australia / Q000453:epidemiology; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000453:epidemiology / Q000628:therapy*; D005865:Gestational Age; D006801:Humans; D011247:Pregnancy; D047928:Premature Birth / Q000209:etiology*; D011795:Surveys and Questionnaires; D015145:Tocolysis / Q000592:standards
D000900:Anti-Bacterial Agents