Participants
Patients with preterm premature rupture of membranes (PPROM) admitted into our hospital between January 2019 and December 2021 were included in this study. Inclusion criteria: all patients including single pregnancy or multiple pregnancy met the diagnostic criteria of spontaneous PPROM[18], with gestational age between 26 0/7 and 33 6/7 weeks. After admission (baseline), all women received a single course of four intramuscular injections of 6 mg dexamethasone at 12-hour intervals to facilitate fetal lung maturity. A 7-day course of therapy of latency antibiotics with a combination of intravenous ampicillin and erythromycin for 48 hours followed by oral amoxicillin and erythromycin was given. Tocolytic agent like nifedipine was cautiously administrated for the first 48 hours if contractions were occurring and avoided if there was evidence of infection. Magnesium sulfate treatment was performed as a neuroprotective in pregnancies at less than 32 0/7 weeks of gestation. Culture for group B streptococci (GBS) were performed for all women.
Exclusion criteria: women with the complications of acute rheumatism, other infections, substantial abnormalities in neurological, psychiatric, cardiac, endocrinological, hematologic, hepatic, renal, or metabolic functions as determined by history, physical examination and blood screening tests were all excluded. Women who had an interval of admission to delivery of more than 7 days or less than 3 days during expectant management were also excluded. Prolongation of pregnancy was associated with a higher risk of chorioamnionitis[18] while a 7-day course of therapy of latency antibiotics is recommended during expectant management as discussed in detail above, and a single course of corticosteroids may persist 48 hours. Therefore, we excluded this condition. The study protocol was approved by the hospital’s ethics committee (No. KS22218).