Active Versus Expectant Management for Preterm Premature Rupture of Membranes at 34-36 Weeks of Gestation and the Associated Adverse Perinatal Outcomes

Abstract Objective: To compare the type of management (active versus expectant) for preterm premature rupture of membranes (PPROM) between 34 and 36 + 6 weeks of gestation and the associated adverse perinatal outcomes in 2 tertiary hospitals in the southeast of Brazil. Methods: In the present retrospective cohort study, data were obtained by reviewing the medical records of patients admitted to two tertiary centers with different protocols for PPROM management. The participants were divided into two groups based on PPROM management: group I (active) and group II (expectant). For statistical analysis, the Student t-test, the chi-squared test, and binary logistic regression were used. Results: Of the 118 participants included, 78 underwent active (group I) and 40 expectant management (group II). Compared with group II, group I had significantly lower mean amniotic fluid index (5.5 versus 11.3 cm, p = 0.002), polymerase chain reaction at admission (1.5 versus 5.2 mg/dl, p = 0.002), time of prophylactic antibiotics (5.4 versus 18.4 hours, p摘要 研究目的：对比巴西东南部两所三级医院内，妊娠34~36+6周的早产胎膜早破（preterm premature rupture of membranes, PPROM）患者的两种管理方案（积极管理与期待管理），及其对应的围产期不良结局。研究方法：本研究为回顾性队列研究，通过查阅两家针对PPROM管理制定不同诊疗规范的三级医疗中心的住院患者病历采集研究数据。依据PPROM的管理方式将研究对象分为两组：I组（积极管理组）与II组（期待管理组）。统计学分析采用t检验、卡方检验及二元logistic回归。研究结果：纳入分析的118例研究对象中，78例接受积极管理（I组），40例接受期待管理（II组）。与II组相比，I组的平均羊水指数显著更低（5.5 cm vs 11.3 cm，p=0.002），入院时聚合酶链式反应（polymerase chain reaction）检测结果为1.5 mg/dl vs 5.2 mg/dl（p=0.002），预防性抗生素使用时长显著更短（5.4小时 vs 18.4小时，p=