Domiciliary Versus Hospital Management of PPROM

NCT ID: NCT04413019

Last Updated: 2021-01-06

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

3662 participants

Study Classification

OBSERVATIONAL

Study Start Date

2019-04-15

Study Completion Date

2020-10-20

Brief Summary

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This study is designed to compare efficacy \& safety of planned domiciliary versus hospital care for women with preterm prelabor rupture of the membranes (PPROM) on fetal, neonatal and maternal outcome.

Detailed Description

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Background: PPROM is encountered in 2.0% to 3.5% of pregnancies. Domiciliary care management is developing more and more in obstetrics, with psychological benefits for patients as well as other financial benefits. Reliable discharge criteria have been mentioned by few studies for patients with PPROM. Studies had shown that domiciliary care management in a context of PPROM did not modify perinatal morbidity and mortality, and allows a prolongation of the latency period. However, eligibility criteria for domiciliary care management were heterogeneous

Aim of The Work: The aim of this study is to compare efficacy \& safety of planned domiciliary versus hospital care for women with preterm prelabor rupture of the membranes (PPROM) on fetal, neonatal and maternal outcome.

Patients \& Methods: The current trial was conducted at Ain Shams University Maternity Hospital. A total of 3662 pregnant women were recruited from the outpatient clinic \& emergency room and included in the study. Then, they were randomized into two groups; group (D) was counseled for home care management, while group (H) was hospitalized. Take-home baby was assessed as a primary outcome and other maternal, fetal \& neonatal complications were recorded \& moreover latency period, mode of delivery \& preference of care were assessed

Conditions

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Preterm Premature Rupture of Membrane

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Group (D): Planned domiciliary care.

Patients within this group will be counseled for home care with self-monitoring for any symptoms suggestive of preterm labor, maternal or fetal distress.

Clinical follow up

Intervention Type OTHER

Patients recruited in this study commenced antibiotic treatment according to the recent guidelines :

* Erythromycin 250 mg 4 times daily for 10 days following the diagnosis of PPROM, or until the women is established labor (whichever sooner)
* Penicillin may be used in patients who can't tolerate erythromycin
* In cases of penicillin allergy: Cefazolin 1 g intravenously every 8 hours for 48 hours, followed by cephalexin 500 mg orally four times daily for five days. These drugs provide coverage for both GBS and Escherichia coli, the two major causes of neonatal infection.

Group (H): Planned hospital care.

Patients within this group will be admitted at hospital for close monitoring of maternal \& fetal wellbeing \& finally the neonatal outcome

Clinical follow up

Intervention Type OTHER

Patients recruited in this study commenced antibiotic treatment according to the recent guidelines :

* Erythromycin 250 mg 4 times daily for 10 days following the diagnosis of PPROM, or until the women is established labor (whichever sooner)
* Penicillin may be used in patients who can't tolerate erythromycin
* In cases of penicillin allergy: Cefazolin 1 g intravenously every 8 hours for 48 hours, followed by cephalexin 500 mg orally four times daily for five days. These drugs provide coverage for both GBS and Escherichia coli, the two major causes of neonatal infection.

Interventions

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Clinical follow up

Patients recruited in this study commenced antibiotic treatment according to the recent guidelines :

* Erythromycin 250 mg 4 times daily for 10 days following the diagnosis of PPROM, or until the women is established labor (whichever sooner)
* Penicillin may be used in patients who can't tolerate erythromycin
* In cases of penicillin allergy: Cefazolin 1 g intravenously every 8 hours for 48 hours, followed by cephalexin 500 mg orally four times daily for five days. These drugs provide coverage for both GBS and Escherichia coli, the two major causes of neonatal infection.

Intervention Type OTHER

Eligibility Criteria

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Exclusion Criteria

* Query PPROM: A history of PPROM with no pooling of amniotic fluid from the cervix on a sterile speculum examination
* Maternal comorbidities (Diabetes mellitus, hypertension, etc.)
* Patients with placenta previa
* Amniotic fluid pocket on ultrasound \< 2x2 cm
* Logistic problems interfering with follow-up
* Inability to check temperature every six hours, with parameters for notifying their clinician (temperature ≥38°C)
* Non-Dependable transportation
Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Ahmed Mohammed Selim

OTHER

Sponsor Role lead

Responsible Party

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Ahmed Mohammed Selim

ASelim

Responsibility Role SPONSOR_INVESTIGATOR

Locations

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Faculty of medicine - Ain Shams university

Cairo, , Egypt

Site Status

Countries

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Egypt

Other Identifiers

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PPROM

Identifier Type: -

Identifier Source: org_study_id

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