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Risk factors associated with shortened latency before delivery in outpatients managed for preterm prelabor rupture of membranes
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International audience. Introduction: Preterm prelabor rupture of membranes (PPROM) occurs in 3% of preg-nancies and is the main cause (~30%) of premature delivery. Home care seems to be a safe alternative for the management of patients with PPROM, who have a longer la-tency than those with PPROM managed with conventional hospitalization. We aimed to identify the risk factors associated with a shortened latency before delivery in women with PPROM managed as outpatients.Material and methods: The design was a retrospective cohort study and the setting was a Monocentric Tertiary centre (Lille University Hospital, France) from 2009 to 2018. All consecutive patients in home care after PPROM at 24–36 weeks were in-cluded. For the main outcome measure we calculated the latency ratio for each pa-tient as the ratio of the real latency period to the expected latency period, expressed as a percentage. The risk factors influencing this latency ratio were evaluated.Results: A total of 234 patients were managed at home after PPROM. Mean latency was 35.5 ± 20.7 days, corresponding to an 80% latency ratio. In 196 (83.8%) patients the length of home care was more than 7 days. A lower latency ratio was significantly associated with oligohydramnios (p< 0.001), gestational age at PPROM (p= 0.006), leukocyte count at PPROM more than 12× 109/L (p= 0.025), and C- reactive protein concentration more than 5 mg/L at 7 days after PPROM (p= 0.046). Cervical length was not associated with a lower latency ratio.Conclusions: Women with PPROM managed with home care are stable. The main risk factor associated with a reduced latency is oligohydramnios. Outpatients with oligohydramnios should be informed of the probability of a shortened latency period.
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