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).