Expectant versus immediate delivery in women with PPROM between 34 and 35⁺⁶ weeks: A Retrospective cohort.

Abstract

Studies comparing the efficacy of expectant management (EM) and immediate delivery (ID) in the management of women with preterm prelabor rupture of membranes (PPROM) between 34 and 35⁺⁶ weeks have not been done in a developing country. Although large multicentric studies show better outcomes with EM, the economic implications have not been studied. This study compared women with PPROM between 34 and 35 ⁺⁶ weeks, managed expectantly with women who were delivered immediately. Large tertiary center and retrospective cohort. Data of 206 women with PPROM between 34 and 35⁺⁶ weeks managed with immediate delivery in the years 2014 and 2015 were compared with seventy-five women with PPROM managed expectantly in the years 2016 and 2017. Data was summarized using mean standard deviation (SD) or median interquartile range for continuous variables and frequency and percentage for categorical variables. Continuous variables were compared using independent <i>t</i>-test and categorical variables were compared using Chi-square statistics. Neonatal sepsis was seen in 1/75 (1.3%) in the group managed expectantly and 12/206 (5.8%) in the ID group (<i>P</i> = 0.109). Respiratory distress was seen in 3/75 (4%) in the group managed expectantly and 22/206 (10.7%) with ID (<i>P</i> = 0.08). Chorioamnionitis was similar in both groups. Cesarean rate was 17.3% with expectant management and 28% with ID (<i>P</i> = 0.065). The mean hospital bill was ₹.33,494/- in the ED group and ₹.27,079/- in the ID group (<i>P</i> < 0.001). Expectant management was more expensive.