Hospital Versus Home Management in Women with Pre-Labor Rupture of Membranes: RCT

Abstract

Abstract Background Pre-labor rupture of membranes (premature rupture of membranes (PROM) is defined as rupture of fetal membranes before onset of labor in women after 37 weeks of gestation. And it accounts for 10% of all gestations. Latent period is the interval between PROM and time of onset of labor. More accurate prediction of latency period could help prepare patients for anticipated length of hospital stays. Objective To find out if there is difference between home management and hospital expectant management in women with PROM as regard maternal and fetal outcomes. Patients and Methods Our study is a prospective randomized controlled trial to compare hospital versus home management in women with PROM, whom came to Ain Shams Maternity Hospital, as regard latency period, successful vaginal delivery, chorioamnionitis, NICU admission, and time from rupture of membrane till delivery, who attending the emergency room during the period from June 2017 till June 2018. A total of 152 pregnant women were included in this study who met inclusion and exclusion criteria, they divided into 2 groups, each 76 woman. Group A discharged home after initial assessment, Group B admitted to hospital. Results The present study found that there was a highly statistically significant difference (p < 0.001) between home group and hospital group as regard length of hospital stay. While there was no significant correlation (p > 0.05) between the two groups as regard mode of delivery or adverse maternal or neonatal outcomes. Conclusion As regard home management for women with PROM in comparison with hospital management, they had longer latent period as well as longer time interval between PROM and delivery, but had a shorter hospitalization stay without negative impact on maternal or fetal outcome. In times of increasing financial pressure on the medical system, outpatient management for PROM seems to be a viable option. Also multiparous women were more satisfied with their care, and reported that they ‘would participate in the study again’ if they were cared for at home rather than in hospital.