Carlan S J, O'Brien W F, Parsons M T, Lense J J
Department of Obstetrics and Gynecology, University of South Florida College of Medicine, Tampa.
Obstet Gynecol. 1993 Jan;81(1):61-4.
To compare length of latency period, gestational age at delivery, and safety in a carefully selected group of patients with preterm premature rupture of the membranes (PROM) randomized to home versus hospital management.
After meeting strict inclusion criteria, 67 patients with preterm PROM were randomized by sealed envelope to home versus hospital expectant management. The groups were managed similarly with pelvic and bed rest. Management included recording of temperature and pulse every 6 hours, daily charting of fetal movements, twice-weekly nonstress test and complete blood count, and weekly ultrasound and visual examination of the cervix.
There was no significant difference in clinical characteristics or perinatal outcome between the groups. There was, however, a significant decrease in both the days of maternal hospitalization and maternal hospital expenses in the home group.
Only a very small proportion of cases of preterm PROM (18%) could meet the strict safety criteria for inclusion used in the study. In the home-management group, length of the latency period and gestational age at delivery were not significantly different than in hospitalized patients.
在一组经过精心挑选的胎膜早破早产患者中，比较随机分配至居家管理与住院管理的患者的潜伏期时长、分娩时的孕周以及安全性。
在满足严格的纳入标准后，67例胎膜早破早产患者通过密封信封随机分配至居家期待管理组与住院期待管理组。两组患者均采取类似的骨盆和卧床休息措施。管理内容包括每6小时记录体温和脉搏、每日记录胎动、每周进行两次无应激试验和全血细胞计数，以及每周进行超声检查和宫颈视诊。
两组之间的临床特征或围产期结局无显著差异。然而，居家管理组的产妇住院天数和住院费用均显著降低。
只有极少数胎膜早破早产病例（18%）能够符合本研究中使用的严格纳入安全标准。居家管理组的潜伏期时长和分娩时的孕周与住院患者相比无显著差异。
