Abstract
Objective To examine outcomes among women with prelabor rupture of membranes (PROM) who declined
induction and chose outpatient expectant management compared with those admitted for
induction.
Study Design This is a retrospective cohort study of term women with singleton, vertex-presenting
fetuses who presented with PROM between July 2016 and June 2017 and were eligible
for outpatient expectant management (n = 166). The primary outcomes were time from PROM to delivery and time from admission
to delivery. Maternal and neonatal outcomes were also compared between groups. Multivariable
linear regressions were used to assess time differences between groups, adjusting
for known maternal and pregnancy characteristics.
Results Compared with admitted patients, women managed expectantly at home had significantly
longer PROM to delivery intervals (median 29.2 vs. 17 hours, p < 0.001), but were more likely to deliver within 24 hours of admission (95.1 vs.
82.9%, p = 0.004). In the adjusted analysis, PROM to delivery was 7 hours longer (95% confidence
interval [CI]: 3.9–10.0) and admission to delivery was 5.3 hours shorter (95% CI:
2.8–7.7) in the outpatient expectant management cohort. There were no differences
in secondary outcomes.
Conclusion Outpatient management of term PROM is associated with longer PROM to delivery intervals,
but shorter admission to delivery intervals.
Keywords
prelabor rupture of membranes - induction of labor - outpatient expectant management
