From the annual meeting of the American College of Obstetricians and Gynecologists.
A new study could help close the gap in varying opinions about when best to deliver a baby after preterm premature rupture of membranes (PPROM), or at least give physicians better information to use when counseling patients with PPROM. Deciding when to deliver after PPROM has always required balancing the desire to delay delivery in order to avoid problems associated with preterm births and the desire to deliver soon in order to avoid the risk of infection.
Dr. Christopher Nold and his associates compared medical records and neonatal intensive care (NICU) data on 195 pregnancies with PPROM. They found that to avoid 95% of the complications of prematurity, it’s best to deliver after 34 weeks, 1 day of gestation. Babies whose delivery was delayed to 35 weeks spent much less time in the NICU. Both of those targets are later in gestation than some institutions choose for delivering pregnancies with PPROM. See more details in my story about the study.
After Dr. Nold presented the findings, a physician in the audience asked the obvious question — which is it? Thirty-five weeks? Or 34 weeks, 1 day? Which would he choose for a woman with PPROM?
Sorry, but there’s no pat answer to that question, at least not from this data, Dr. Nold replied. Still, the findings do give physicians more information when discussing with the mother the pros and cons of different delivery strategies. That’s definitely progress.
I’d be interested in hearing from physicians who delivery babies — which would you choose, 34 weeks and 1 day, or 35 weeks, if you could delay a PPROM delivery that long? Read the full article, and let me know if you’d you rather reduce the risk of a complication of prematurity, or reduce NICU stay.