Preterm premature rupture of membranes in the late preterm period: an argument against expectant management

IF 3.8 2区医学 Q1 OBSTETRICS & GYNECOLOGY

American Journal of Obstetrics & Gynecology Mfm Pub Date : 2025-03-01 DOI:10.1016/j.ajogmf.2025.101619

Ghamar Bitar MD, Baha M. Sibai MD

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引用次数: 0

Abstract

Preterm premature rupture of membranes is defined as the leakage of amniotic fluid through the cervical os before 37 weeks of gestation and before the onset of labor and complicates nearly 3% of deliveries and 30% of indicated late preterm deliveries. The current management of preterm premature rupture of membranes, which occurs between 34 and 36 weeks of gestation, has pivoted from recommending delivery to recommending either delivery or expectant management because of a large trial that evaluated these management strategies. The potential neonatal benefits of expectant management, reducing complications of prematurity, must be weighed with the maternal risks (and, therefore, attached neonatal risks) of prolonging the gestation under close surveillance. Proceeding towards delivery is recommended for preterm premature rupture of membranes occurring at or later than 34 weeks gestation, given the higher risk of maternal complications, specifically hemorrhage and infection, with expectant management. Furthermore, limited evidence exists to prove the increased risks of adverse neonatal outcomes, including sepsis or composite neonatal morbidity, with immediate delivery compared with expectant management.

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来源期刊

American Journal of Obstetrics & Gynecology Mfm Medicine-Medicine (all)

CiteScore

7.40

自引率

3.20%

发文量

254

审稿时长

40 days

期刊介绍： The American Journal of Obstetrics and Gynecology (AJOG) is a highly esteemed publication with two companion titles. One of these is the American Journal of Obstetrics and Gynecology Maternal-Fetal Medicine (AJOG MFM), which is dedicated to the latest research in the field of maternal-fetal medicine, specifically concerning high-risk pregnancies. The journal encompasses a wide range of topics, including: Maternal Complications: It addresses significant studies that have the potential to change clinical practice regarding complications faced by pregnant women. Fetal Complications: The journal covers prenatal diagnosis, ultrasound, and genetic issues related to the fetus, providing insights into the management and care of fetal health. Prenatal Care: It discusses the best practices in prenatal care to ensure the health and well-being of both the mother and the unborn child. Intrapartum Care: It provides guidance on the care provided during the childbirth process, which is critical for the safety of both mother and baby. Postpartum Issues: The journal also tackles issues that arise after childbirth, focusing on the postpartum period and its implications for maternal health. AJOG MFM serves as a reliable forum for peer-reviewed research, with a preference for randomized trials and meta-analyses. The goal is to equip researchers and clinicians with the most current information and evidence-based strategies to effectively manage high-risk pregnancies and to provide the best possible care for mothers and their unborn children.