title: Expectant management of PPROM and major complications before planned delivery: a retrospective cohort study.
abstract: Women with pre-term pre-labour rupture of membranes (PPROM) 22-33 weeks' gestation were included in a retrospective cohort study with a structured audit to identify risk factors of major complications following PPROM and to assess whether these complications are predictable. Of the 234 women analysed, 106 (45%) delivered within three days. Eighty-four women (36%) had at least one major complication and 45% of these complications occurred within three days. The complication rate was 64% in early PPROM before 28 weeks' gestation and 11% in late PPROM at 28 weeks' gestation or later. Nulliparous women had an increased risk of major complications (adjusted hazards ratio: 3.07 (95% confidence interval: 1.28-7.37)). The complication rates were highest in early PPROM and during the first three days after PPROM. Multiparous women with late PPROM, who do not deliver within the first three days, have the lowest risk of major complications and are suitable for home care.
authors.affiliation: a Department of Gynaecology & Obstetrics , Nordsjaellands Hospital, Hillerod, University of Copenhagen , Denmark.
authors.forename: J M
authors.initials: JM
authors.lastname: Bendix
authors.affiliation: b The Research Unit Women's and Children's Health, the Juliane Marie Centre, Rigshospitalet, University of Copenhagen , Denmark.
authors.forename: H K
authors.initials: HK
authors.lastname: Hegaard
authors.affiliation: a Department of Gynaecology & Obstetrics , Nordsjaellands Hospital, Hillerod, University of Copenhagen , Denmark.
authors.forename: T
authors.initials: T
authors.lastname: Bergholt
authors.affiliation: c Department of Obstetrics , the Juliane Marie Centre, Rigshospitalet, University of Copenhagen , Denmark.
authors.forename: J
authors.initials: J
authors.lastname: Langhoff-Roos
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000628:therapy*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D010298:Parity; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000628:therapy*; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D012307:Risk Factors; D015145:Tocolysis
keywords: Chorioamnionitis; PPROM; cord prolapse; general obstetrics; place of care; placental abruption