[Management of preterm and prelabour rupture of membranes in France]

Abstract

Introduction: Preterm premature rupture of the membranes (PPROM) is a frequent complication of pregnancy leading to prematurity and neonatal infection. The management of PPROM is not consensual in France and practices between maternities are variable. We subjected type 2B and 3 maternity units to a questionnaire regarding their practices concerning the PPROM.

Results: Our study includes 59 type 2B maternity units and 59 type 3 maternity units. Corticotherapy is proposed in all of type 3 maternity units and in 96.5% of type 2B maternity units. Antibiotics are administered at the patient admission in 96.6% of type 3 maternity units and 86% of type 2B maternity units. Tocolytics are used systematically in 31% of maternity units and only in case of contractions in 62% of maternity units. No maternity unit indicates birth systematically after corticotherapy before 32 weeks of gestation (WG). An early delivery is proposed in 9.5% of maternity units between 32 and 34 WG and in 58% of maternity units between 34 and 37 WG.

Conclusion: Corticotherapy and antibiotics are predominantly administered at the time of the diagnosis, as recommended by the HAS and CNGOF. Despite the lack of recommendation, an expectative management until 34 WG, in absence of any sign of chorioamnionitis, seems to be the choice of most maternity units.