Document Detail


Cost-effectiveness of induction after preterm premature rupture of the membranes.
MedLine Citation:
PMID:  12439494     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Our purpose was to design a decision analytic model to evaluate the optimal length of time for expectant management after preterm premature rupture of the membranes between 32 and 36 weeks' gestation. STUDY DESIGN: Five models were created for 32 to 36 weeks' gestation. Probabilities for outcomes were obtained from medical center databases. Cost data were collected from the Health Care Microsystem database and were based on 1996 dollars. RESULTS: The optimal time of delivery to minimize major morbidity was 34 to 36 weeks' gestation, depending on the time of rupture. When only major morbidity was considered, the most cost-effective approach between 32 to 34 weeks was to deliver 1 week after rupture. At 35 to 36 weeks, the most cost-effective approach was to deliver at presentation. CONCLUSION: The current method of treating all patients with ruptured membranes similarly and delivery at 34 weeks' gestation is not risk minimizing or cost-effective. By delivery 1 week after rupture at 32 to 34 weeks and immediately at 35 to 36 weeks, significant morbidity can be avoided.
Authors:
Ian A Grable
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  187     ISSN:  0002-9378     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  2002 Nov 
Date Detail:
Created Date:  2002-11-20     Completed Date:  2002-12-31     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1153-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA. igrable@caregroup.harvard.edu
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MeSH Terms
Descriptor/Qualifier:
Cost-Benefit Analysis
Databases, Factual
Delivery, Obstetric
Female
Fetal Membranes, Premature Rupture / therapy*
Gestational Age
Humans
Labor, Induced / economics*
Pregnancy
Pregnancy Outcome
Probability
Comments/Corrections
Comment In:
Am J Obstet Gynecol. 2003 Jul;189(1):305; author reply 305   [PMID:  12861177 ]
Am J Obstet Gynecol. 2003 Jul;189(1):305; author reply 306   [PMID:  12861179 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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