Planned domiciliary versus hospital care for women with Preterm Prelabour Rupture of the Membranes (PPROM)

Background: PPROM is encountered in 2.0% to 3.5% of pregnancies. Domiciliary care management is developing more and more in obstetrics for the psychological and financial burden of hospital care management to the patient but unfortunately, there were insufficient studies for reliable discharge criteria for the patient with PPROM. Objective: To compare efficacy & safety of planned domiciliary versus hospital care for women with PPROM on the fetal, neonatal, and maternal outcome. Design: The current study was conducted at Ain Shams University Maternity Hospital. A total of 4700 pregnant women were recruited from the outpatient clinic & emergency room and 3662 women were included in the study. Patient and methods: They were divided into two groups according to their preference; group (D) was counseled for domiciliary care, while group (H) was hospitalized. Take-home baby was assessed as a primary outcome and other maternal, fetal, and neonatal complications were recorded, moreover, latency period and mode of delivery were assessed. Results: When the two groups were compared, the number of take-home babies among the domiciliary group was 1726 (94.3%) while the number of take-home babies among the hospital group was 1681 (91.8%) representing that the number of take-home babies was significantly more frequent among the domiciliary group and there were also significant differences between the two groups as regard maternal and fetal outcomes in favor of the domiciliary management. Conclusions: We concluded that both types of care; domiciliary and hospital care can be applied safely after PPROM. The results of our study are assumed to have profound cost-saving effects in favor of domiciliary care, an important aspect regarding the ever-increasing health care costs and workloads.