Clinician's Approach to Antibiotic Treatment and Management of Preterm Prelabour Rupture of Membranes (PPROM) in Australia and Aotearoa New Zealand-A Survey.

IF 1.4 4区 医学 Q3 OBSTETRICS & GYNECOLOGY
Sonia Kua, Amanda Poprzeczny, Katie Groom, Matthew Payne, John Newnham, Brett Manley, Clare L Whitehead
{"title":"Clinician's Approach to Antibiotic Treatment and Management of Preterm Prelabour Rupture of Membranes (PPROM) in Australia and Aotearoa New Zealand-A Survey.","authors":"Sonia Kua, Amanda Poprzeczny, Katie Groom, Matthew Payne, John Newnham, Brett Manley, Clare L Whitehead","doi":"10.1111/ajo.70039","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Preterm prelabour rupture of membranes (PPROM) is a common obstetric complication with significant maternal and foetal consequences. There is a lack of contemporary evidence regarding the optimal management of PPROM, including the best antibiotic regimen and management at previable gestations.</p><p><strong>Aims: </strong>To understand the contemporary management of PPROM among clinicians in Australia and Aotearoa New Zealand.</p><p><strong>Materials and methods: </strong>An anonymous web-based survey was designed and distributed, consisting of 31 questions about individual clinicians' routine management of PPROM across a range of different gestations.</p><p><strong>Results: </strong>The survey was completed by 235 clinicians from across Australia and Aotearoa New Zealand. The majority (225/232, 97%) routinely prescribed prophylactic antibiotics after PPROM, with 90 different antibiotic regimens documented. The most commonly prescribed prophylactic antibiotics were erythromycin (198/225, 88%) and penicillins (103/225, 46%). There was variation in practice regarding the timing of birth after PPROM, with 62% (147/235) routinely delaying birth until after 37 weeks of gestation, and 61% (143/235) expediting birth after 34 weeks of gestation if Group B Streptococcus was cultured antenatally. For previable PPROM (< 22 weeks of gestation), 74% (171/232) of women were routinely admitted to hospital at the time of diagnosis and 77% (173/225) were routinely offered antibiotics. There was significant variation in the earliest gestational ages at which antenatal corticosteroids and resuscitation are offered.</p><p><strong>Conclusions: </strong>We observed wide variation in clinical practice of management of PPROM. With a lack of national consensus regarding optimal management of this common pregnancy complication, contemporary clinical trials to define best practices are required.</p>","PeriodicalId":55429,"journal":{"name":"Australian & New Zealand Journal of Obstetrics & Gynaecology","volume":" ","pages":""},"PeriodicalIF":1.4000,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Australian & New Zealand Journal of Obstetrics & Gynaecology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/ajo.70039","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Preterm prelabour rupture of membranes (PPROM) is a common obstetric complication with significant maternal and foetal consequences. There is a lack of contemporary evidence regarding the optimal management of PPROM, including the best antibiotic regimen and management at previable gestations.

Aims: To understand the contemporary management of PPROM among clinicians in Australia and Aotearoa New Zealand.

Materials and methods: An anonymous web-based survey was designed and distributed, consisting of 31 questions about individual clinicians' routine management of PPROM across a range of different gestations.

Results: The survey was completed by 235 clinicians from across Australia and Aotearoa New Zealand. The majority (225/232, 97%) routinely prescribed prophylactic antibiotics after PPROM, with 90 different antibiotic regimens documented. The most commonly prescribed prophylactic antibiotics were erythromycin (198/225, 88%) and penicillins (103/225, 46%). There was variation in practice regarding the timing of birth after PPROM, with 62% (147/235) routinely delaying birth until after 37 weeks of gestation, and 61% (143/235) expediting birth after 34 weeks of gestation if Group B Streptococcus was cultured antenatally. For previable PPROM (< 22 weeks of gestation), 74% (171/232) of women were routinely admitted to hospital at the time of diagnosis and 77% (173/225) were routinely offered antibiotics. There was significant variation in the earliest gestational ages at which antenatal corticosteroids and resuscitation are offered.

Conclusions: We observed wide variation in clinical practice of management of PPROM. With a lack of national consensus regarding optimal management of this common pregnancy complication, contemporary clinical trials to define best practices are required.

临床医生对澳大利亚和新西兰产前胎膜破裂(PPROM)的抗生素治疗和管理方法的调查。
背景:早产产前胎膜破裂(PPROM)是一种常见的产科并发症,具有显著的母婴后果。关于PPROM的最佳管理缺乏当代证据,包括最佳抗生素方案和前妊娠的管理。目的:了解澳大利亚和新西兰临床医生对PPROM的当代管理。材料和方法:设计并分发了一份匿名网络调查,包括31个问题,涉及临床医生在不同妊娠期对PPROM的常规管理。结果:该调查由来自澳大利亚和新西兰的235名临床医生完成。大多数(225/ 232,97%)在PPROM后常规开具预防性抗生素,记录了90种不同的抗生素方案。最常用的预防性抗生素是红霉素(198/ 225,88%)和青霉素类(103/ 225,46%)。PPROM后的分娩时间在实践中存在差异,62%(147/235)的患者常规延迟分娩至妊娠37周后,61%(143/235)的患者在妊娠34周后提前分娩,如果产前培养B群链球菌。结论:我们观察到临床治疗PPROM的方法存在很大差异。由于缺乏关于这种常见妊娠并发症的最佳管理的全国共识,需要当代临床试验来确定最佳做法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
3.40
自引率
11.80%
发文量
165
审稿时长
4-8 weeks
期刊介绍: The Australian and New Zealand Journal of Obstetrics and Gynaecology (ANZJOG) is an editorially independent publication owned by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) and the RANZCOG Research foundation. ANZJOG aims to provide a medium for the publication of original contributions to clinical practice and/or research in all fields of obstetrics and gynaecology and related disciplines. Articles are peer reviewed by clinicians or researchers expert in the field of the submitted work. From time to time the journal will also publish printed abstracts from the RANZCOG Annual Scientific Meeting and meetings of relevant special interest groups, where the accepted abstracts have undergone the journals peer review acceptance process.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信