Comparison of outpatient versus inpatient management after early stabilization in preterm prelabor rupture of membranes <34 weeks: Maternal safety, latency, and neonatal outcomes.

Authors

Orhan Ay, Fethiye Şahin, Pelin Bahçeci, Deniz Taşkıran, Kazım Gezginç

Published in

International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics. Jul 03, 2026. Epub Jul 03, 2026.

Abstract

This study compared outpatient/home follow-up after initial stabilization with inpatient management in singleton pregnancies with preterm prelabor rupture of membranes (PPROM) before 34 + 0 weeks of gestation, focusing on maternal safety, neonatal outcomes, latency, and healthcare utilization.
In this single-center retrospective cohort, singleton PPROM cases managed between January 2020 and December 2024 were evaluated. After stabilization, patients were classified as outpatient/home or inpatient. The primary outcome was neonatal intensive care unit (NICU) admission. Inverse probability of treatment weighting (IPTW) was used to reduce selection bias, and latency was assessed with landmark Kaplan-Meier analyses.
A total of 239 cases were analyzed (inpatient, n = 173; outpatient/home, n = 66). NICU admission was lower in the outpatient/home group (unadjusted risk ratio [RR] 0.56; IPTW RR 0.59, P = 0.007). The outpatient/home group had higher gestational age at delivery (median 36 vs. 31 weeks), shorter NICU stay (IPTW median difference, -4 days), and greater birth weight (IPTW median difference, +980 g). Placental abruption was more frequent in the outpatient/home group (IPTW RR 2.48). Landmark analyses showed markedly longer additional latency in the outpatient/home group (after 48 h: 43 vs. 3 days; after 7 days: 38 vs. 5 days; log-rank P < 0.001).
In carefully selected, initially stable PPROM cases before 34 weeks, outpatient/home management was associated with longer latency and lower NICU utilization. However, these findings should be interpreted cautiously because more stable patients might have been preferentially selected for outpatient follow-up. With careful selection and close surveillance, outpatient/home management might be a reasonable alternative to reduce inpatient resource use.

PMID:
42400201
Bibliographic data and abstract were imported from PubMed on 04 Jul 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.