Preterm premature rupture of membranes ≥ 32 weeks' gestation: impact of revised practice guidelines.
Obstetrics & Gynecology
American journal of obstetrics and gynecology
Adult, Female, Fetal Membranes, Premature Rupture, Gestational Age, Guideline Adherence, Humans, Practice Guidelines as Topic, Pregnancy, Pregnancy Trimester, Third, Retrospective Studies
OBJECTIVE: The purpose of this study was to determine the perinatal impact of the 2007 American College of Obstetricians and Gynecologists Practice Bulletin on preterm premature membrane rupture.
STUDY DESIGN: Perinatal outcomes were compared in women who had experienced preterm membrane rupture in the 3 years before the 2007 Practice Bulletin to similar women who experienced preterm premature rupture of membranes in the 3 years after the issue and implementation of the guideline.
RESULTS: After adjustment for gestational age at membrane rupture and steroids, composite severe morbidity (death, respiratory distress syndrome, assisted ventilation for ≥ 6 hours, sepsis, pneumonia, grade 3 or 4 intraventricular hemorrhage, or necrotizing enterocolitis) was similar by group. Infants in the "after" group experienced less pneumonia and sepsis, similar respiratory morbidity, but more labor inductions and postpartum hemorrhage.
CONCLUSION: The new guideline significantly decreases severe neonatal infections but is associated with more frequent labor induction and postpartum hemorrhage.
Faksh, Arij; Wax, Joseph R; Lucas, F Lee; Cartin, Angelina; and Pinette, Michael G, "Preterm premature rupture of membranes ≥ 32 weeks' gestation: impact of revised practice guidelines." (2011). Maine Medical Center. 2161.