1 Medical Specialty in Obstetrics and
Gynaecology, Pontifical Catholic University of Quito, Quito - Ecuador.
2 Attending physician of the HECAM Obstetrics and
Gynaecology service / Professor of the PUCE School of Medicine, Quito -
Ecuador.
3 Clinical-Health Pathologist / Teacher, School of
Medicine PUCE, Quito - Ecuador.
Correspondence information:
Author’s name. Amanda Angélica Jácome Espinoza.
Address. Luis A. Guerra y 10 de Agosto, Puyo - Ecuador, Postal Code:
160150.
E-mail. angeajes@hotmail.es
Phone number. (+593) 995600441
As mentioned article: Jácome A, Hidalgo R, Carrasco L, Chavez
S. Expectant management vs active management of premature membrane
breakage: A retrospective cohort study. Quito- Ecuador,
2020.
ABSTRACT
Objective: To evaluate the expectant management (EM) versus
active management (AM) of PROM (Premature Rupture of Membranes) in
pregnancies more than 34 weeks of gestation as a factor associated with
a decrease of neonatal complications because of prematurity.Design: A retrospective cohort study. Setting:Pregnancy women with 34‒36.6 weeks of gestation with PROM attended in
Carlos Andrade Marín Specialty Hospital, Quito-Ecuador; in the years
2016 and July 2019. Population: 209 patients: this sample was
separately in two groups by inclusion and exclusion criteria; 103 cases
were management expectantly and 106 cases were management actively.Methods: The risk was estimated calculation relative risk (RR)
and Chi-square with p‒value less than 0.05, 95% CI. Main
Outcome Measures: frequency of neonatal complications in both groups.Results: The prevalence of PROM was 1.95%, associated with
preterm delivery in 13.59%. Caesarean delivery was 25.2% (EM) and
50.9% (AM) with p <0.05. There were no significant
differences in variables: maternal infection RR: 1,324 (95% CI:
0.972‒1.885) in EM and AM: RR: 0.683 (95% CI: 0.398‒1.172); neonatal
sepsis RR: 0.909 (95% CI: 0.608‒1359) in EM, and RR: 1.091 (95% CI:
0.773‒1540) in AM; respiratory distress syndrome RR: 0.993 (expectant)
and RR: 1.01 (active), and prolonged hospitalization. The risk of
neonatal mortality and necrotizing enterocolitis is higher in newborns
of mothers under AM, with RR: 2,013 (95% CI: 1,723‒2351).Conclusions: There were no significant differences between both
groups, but there was a significant increase in neonatal mortality,
necrotizing enterocolitis, and caesarean after active management.
Key words: premature rupture of membranes, expectant
management, active management, neonatal complications.