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Optimal time for delivery with preterm premature rupture of membranes from 32 to 36 6/7 weeks.
MedLine Citation:
PMID:  21142773     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Objective. To evaluate the optimal time for delivery in singleton pregnancies with preterm premature rupture of membranes (PPROM) when delivered between 32 and 36 6/7 weeks gestational age (GA). Study design. We performed a retrospective cohort study of all singleton pregnancies with PPROM who delivered between 32 and 36 6/7 weeks gestation at our institution. We matched the delivery and NICU datasets to determine composite morbidity (COMP MORB) and NICU length of stay (LOS) stratified by weeks of gestation. COMP MORB was defined as one or more of: bronchopulmonary dysplasia, respiratory distress syndrome, necrotizing entercolitis, intraventricular hemorrhage, dissiminated intravascular coagulation, and culture proven sepsis. We used χ(2) and student 't' test as appropriate and a receiver operating characteristc curve (ROC). Results. There were 195 newborns with PPROM with a range of 30 babies at 36 weeks to a high of 53 at 34 weeks. The mean (±SD) NICU LOS was 22.5 (±9.9) days at 32 weeks, 17.8 (±10.0) days at 33 weeks, 14.8 (±11.0) days at 34 weeks, 4.5 (±4.7) days at 35 weeks, and 1.5 (±4.4) days at 36 weeks (p <0.0001). There was no difference in duration of ROM by GA with a range of 6.8 to 1.9 by week (p = NS). The ROC curve had a cut point for COMP MORB at 34.1 weeks GA (sens = 95%, FPR 48.6%, area under curve 0.782, p = 0.0002). Conclusion. Our study suggests that delivery of PPROM pregnancies at 34.1 weeks GA avoids 95% of composite morbidity, and delivery after 35 weeks GA will decrease the NICU LOS.
Authors:
Christopher Nold; Naveed Hussain; Kathleen Smith; Winston Campbell; Adam Borgida; James Egan
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2010-12-10
Journal Detail:
Title:  The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians     Volume:  -     ISSN:  1476-4954     ISO Abbreviation:  -     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-12-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101136916     Medline TA:  J Matern Fetal Neonatal Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Obstetrics and Gynecology, University of Conn. Health Center, Farmington, Connecticut, USA.
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