Impact of the new guidelines on the management of premature rupture of membranes for the prevention of late preterm birth: an 11-year retrospective study
-
Noémie Bouchet
,
Arnaud Joal
Abstract
Objectives
To evaluate the number of late preterm (LPT) births (between 34 0/7 and 36 6/7 weeks) that could have been prevented if expectant management of preterm premature rupture of membranes (PPROM) had been applied according to new recommendations.
Methods
A retrospective cohort study included all births at one Swiss center between January 1, 2002 and December 31, 2012. Births were categorized using an adapted evidence-based classification. Two scenarios were considered: best scenario (maximum averted cases) and a conservative scenario (minimum averted cases).
Results
Among 2017 LPT births (5.0% of all deliveries; n=40,609), 1122 (60.6%) women had PPROM. Spontaneous labor occurred in 473 (42.2%) cases and 649 (57.8%) had induction of labor or an elective cesarean section. In the latter group, 44 (6.8%) had evidence-based indications for LPT delivery and 605 (83.2%) had non-evidence-based indications. Depending on the scenario, the rate of avoided LPT cases would have varied between 4.2% (95% confidence interval [CI]: 3.4–5.2) if the conservative scenario was applied, and 30% (95% CI: 28.0–32.0) for the best scenario.
Conclusion
Adoption of new guidelines for the management of PPROM will prevent a considerable number of LPT births and help decrease the adverse effects and potential disability associated with late preterm infants.
Acknowledgments
We thank all research midwives and administrative staff at the obstetrics service of Geneva University Hospitals for their help with database development. We sincerely thank Rosemary Sudan for editorial assistance. The project received institutional support from the Department of Gynecology and Obstetrics, Geneva University Hospitals.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
Conflict of interests: All authors declare no conflicts of interest relevant to this article to disclose.
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©2019 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Frontmatter
- Editorial
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- Antenatal magnesium sulfate for fetal neuroprotection: a critical appraisal and systematic review of clinical practice guidelines
- Research Articles – Obstetrics
- Customised birthweight standard for a Slovenian population
- Clinical chorioamnionitis at term IX: in vivo evidence of intra-amniotic inflammasome activation
- A high concentration of fetal fibronectin in cervical secretions increases the risk of intra-amniotic infection and inflammation in patients with preterm labor and intact membranes
- Associations between second-trimester amniotic fluid levels of ADAMTS4, ADAMTS5, IL-6, and TNF-α and spontaneous preterm delivery in singleton pregnancies
- Metabolic characterization of amniotic fluids of fetuses with enlarged nuchal translucency
- Stillbirths in women with pre-gravid obesity
- Dependencies between maternal and fetal autonomic tone
- Placental thickness on ultrasound and neonatal birthweight
- Quantitative and qualitative assessment of maternal sexuality during pregnancy
- Impact of the new guidelines on the management of premature rupture of membranes for the prevention of late preterm birth: an 11-year retrospective study
- Diabetes and obesity during pregnancy are associated with oxidative stress genotoxicity in newborns
- Prenatal diagnosis, associated findings and postnatal outcome of fetuses with double outlet right ventricle (DORV) in a single center
- Research Article – Newborn
- Therapeutic hypothermia during neonatal transport at Regional Perinatal Centers: active vs. passive cooling
Articles in the same Issue
- Frontmatter
- Editorial
- Tinker, tailor, infection, inflammation
- Review
- Antenatal magnesium sulfate for fetal neuroprotection: a critical appraisal and systematic review of clinical practice guidelines
- Research Articles – Obstetrics
- Customised birthweight standard for a Slovenian population
- Clinical chorioamnionitis at term IX: in vivo evidence of intra-amniotic inflammasome activation
- A high concentration of fetal fibronectin in cervical secretions increases the risk of intra-amniotic infection and inflammation in patients with preterm labor and intact membranes
- Associations between second-trimester amniotic fluid levels of ADAMTS4, ADAMTS5, IL-6, and TNF-α and spontaneous preterm delivery in singleton pregnancies
- Metabolic characterization of amniotic fluids of fetuses with enlarged nuchal translucency
- Stillbirths in women with pre-gravid obesity
- Dependencies between maternal and fetal autonomic tone
- Placental thickness on ultrasound and neonatal birthweight
- Quantitative and qualitative assessment of maternal sexuality during pregnancy
- Impact of the new guidelines on the management of premature rupture of membranes for the prevention of late preterm birth: an 11-year retrospective study
- Diabetes and obesity during pregnancy are associated with oxidative stress genotoxicity in newborns
- Prenatal diagnosis, associated findings and postnatal outcome of fetuses with double outlet right ventricle (DORV) in a single center
- Research Article – Newborn
- Therapeutic hypothermia during neonatal transport at Regional Perinatal Centers: active vs. passive cooling
