Sreedhar Shruthi, Rathore Swati, Benjamin Santosh, Gowri M, Mathews Jiji E
Department of Obstetrics and Gynecology, Christian Medical College, Vellore, Tamil Nadu, India.
Department of Biostatistics, Christian Medical College, Vellore, Tamil Nadu, India.
J Family Med Prim Care. 2020 Jul 30;9(7):3225-3229. doi: 10.4103/jfmpc.jfmpc_146_20. eCollection 2020 Jul.
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 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 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 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 -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 ( = 0.109). Respiratory distress was seen in 3/75 (4%) in the group managed expectantly and 22/206 (10.7%) with ID ( = 0.08). Chorioamnionitis was similar in both groups. Cesarean rate was 17.3% with expectant management and 28% with ID ( = 0.065). The mean hospital bill was ₹.33,494/- in the ED group and ₹.27,079/- in the ID group ( < 0.001).
Expectant management was more expensive.
在发展中国家，尚未开展过比较期待治疗（EM）和即刻分娩（ID）对34至35周胎膜早破（PPROM）孕妇治疗效果的研究。尽管大型多中心研究显示期待治疗有更好的结局，但尚未对其经济影响进行研究。
本研究比较了34至35周胎膜早破且接受期待治疗的孕妇与即刻分娩的孕妇。
大型三级中心及回顾性队列研究。
将2014年和2015年接受即刻分娩的206例34至35周胎膜早破孕妇的数据，与2016年和2017年接受期待治疗的75例胎膜早破孕妇的数据进行比较。
连续变量采用均数标准差（SD）或中位数四分位数间距进行总结，分类变量采用频率和百分比进行总结。连续变量采用独立样本t检验进行比较，分类变量采用卡方统计进行比较。
期待治疗组中1/75（1.3%）发生新生儿败血症，即刻分娩组中12/206（5.8%）发生新生儿败血症（P = 0.109）。期待治疗组中3/75（4%）出现呼吸窘迫，即刻分娩组中22/206（10.7%）出现呼吸窘迫（P = 0.08）。两组绒毛膜羊膜炎情况相似。期待治疗组剖宫产率为17.3%，即刻分娩组为28%（P = 0.065）。急诊组平均住院费用为33,494卢比，即刻分娩组为27,079卢比（P < 0.001）。
期待治疗费用更高。
