Impact du mode de suivi des ruptures prématurées des membranes avant 36 SA sur la durée de latence

Abstract

Introduction: Preterm premature rupture of membranes (PPROM) is the main cause of premature delivery, complicating 1-3% of all pregnancies. Conventional hospitalization (CH) is the most frequent mode of follow-up, but homecare (HC) seems to be an alternative.Objectives: Study of the impact of the monitoring mode on the duration of the latency period and on the latency ratio after PPROM, and analysis of the risk factors modifying this ratio.Methods: This was a bicentric retrospective cohort study here-abouts including patients who presented a PPROM between 24 and 36 weeks of gestation from 2016 to 2018. Patients had a follow-up in HC at Lille University Hospital center (UHC) and in CH at Nantes UHC according to two different follow-up protocols. The latency ratio corresponded to the real latency period divided by the latency period to theoretical term.Results: We included 154 patients : 102 in HC and 52 in CH. The mean latency period was significantly higher in HC : 36.9±21.8 days, corresponding to an 85.5±23.7% latency ratio versus 20.2±12 days, corresponding to an 66.9±29.8% latency ratio in CH (p< 0.001). The latency ratio in CH was correlated with term at PPROM (p = 0.001).Conclusions: The duration of the latency period seems prolonged for PPROM followed by HC management versus CH in selected populations. This study suggests a benefit to HC in stable patients.