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Evidence summaries

Planned Home Vs Hospital Care for Preterm Prelabour Rupture of the Membranes (Pprom)

There is insufficient evidence of planned home versus hospital care for preterm prelabour rupture of the membranes (PPROM) prior to 37 weeks' gestation. Level of evidence: "D"

A Cochrane review [Abstract] 1 included 2 studies with a total of 116 subjects. Women were monitored for 48 to 72 hours before randomisation for planned home vs hospital management for preterm prelabour rupture of membranes (PPROM). Perinatal mortality was reported in one trial but the study was underpowered to find a difference. There was no evidence of differences between groups for serious neonatal morbidity, chorioamnionitis, gestational age at delivery, birthweight and admission to neonatal intensive care. There was no information on serious maternal morbidity or mortality. There was some evidence that women managed in hospital were more likely to delivere by caesarean section (RR 0.28, 95% CI 0.07 to 1.15, moderate heterogeneity I² = 35%). Home care was associated with reduced costs.

Comment: The quality of evidence is downgraded by imprecise results (limited study size for each comparison and few outcome events) and by potential reporting bias (only few small trials reported).

References

  • Abou El Senoun G, Dowswell T, Mousa HA. Planned home versus hospital care for preterm prelabour rupture of the membranes (PPROM) prior to 37 weeks' gestation. Cochrane Database Syst Rev 2010 Apr 14;4:CD008053 [Review content assessed as up-to-date: 28 August 2013]. [PubMed]

Primary/Secondary Keywords