{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T11:10:47Z","timestamp":1777633847849,"version":"3.51.4"},"reference-count":23,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T00:00:00Z","timestamp":1775520000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T00:00:00Z","timestamp":1775520000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>In preterm pre\u2010labor rupture of membranes (PPROM) before 34\u2009weeks, expectant management is preferred in the absence of infection to reduce neonatal morbidity. Outpatient management (OM) has emerged as a potential alternative to prolonged hospitalization, but selection criteria remain ill\u2010defined. Our objective was to evaluate latency between PPROM and delivery, and obstetric and neonatal outcomes before and after the implementation of an OM protocol and its subsequent extensions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods<\/jats:title>\n                    <jats:p>We included all women with PPROM before 34\u2009weeks admitted between January 1, 2011, and December 31, 2021. Two periods were compared: Period A (January 2011\u2013April 2013), when all patients were hospitalized until delivery, and Period B (May 2013\u2013December 2021), when eligible patients were offered OM. Period B was subdivided into three phases (B1\u2013B3) reflecting progressive expansion of eligibility criteria\u2014from stable singleton pregnancies with cephalic presentation and normal amniotic fluid (B1), to inclusion of twins and shorter stabilization periods (B2), and finally cases with oligohydramnios or non\u2010cephalic presentations (B3).<\/jats:p>\n                    <jats:p>The primary outcome was latency period (days between PPROM and delivery). Secondary outcomes included obstetric and neonatal complications. Comparisons were made between Periods A and B and across OM subperiods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 539 patients were included: 145 in Period A and 394 in Period B, of whom 126 (32%) received OM. Mean gestational age at PPROM was similar between periods (28.9\u2009\u00b1\u20093.1 vs. 28.9\u2009\u00b1\u20093.3\u2009weeks;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.94), as were latency (median 7 [3\u201317] days vs. 8 [2\u201321];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.66) and gestational age at delivery (30.8\u2009\u00b1\u20093.3 vs. 30.9\u2009\u00b1\u20093.8\u2009weeks;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.62). Early neonatal bacterial infection was significantly lower in Period B (24.2% vs. 34.5%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01). OM use increased steadily from B1 to B3 without prolonging latency or worsening outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Following OM protocol implementation, one\u2010third of eligible women with PPROM before 34\u2009weeks were managed at home. Outpatient care, even with broadened eligibility, appeared safe, did not increase maternal or neonatal morbidity, and may reduce early neonatal infections without extending latency.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aogs.70162","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T11:13:47Z","timestamp":1775560427000},"page":"896-903","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Management of preterm pre\u2010labor rupture of membranes between 24 and 34\u2009weeks: A before\u2010and\u2010after study of the implementation and modifications of an outpatient management protocol"],"prefix":"10.1111","volume":"105","author":[{"given":"Antonin","family":"Seyral","sequence":"first","affiliation":[{"name":"Port Royal Maternity Unit, Assistance Publique\u2010H\u00f4pitaux de Paris, H\u00f4pital Cochin FHU Prem'impact  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7826-2746","authenticated-orcid":false,"given":"Mathilde","family":"Barrois","sequence":"additional","affiliation":[{"name":"Port Royal Maternity Unit, Assistance Publique\u2010H\u00f4pitaux de Paris, H\u00f4pital Cochin FHU Prem'impact  Paris France"},{"name":"Assistance Publique\u2014H\u00f4pitaux de Paris (AP\u2010HP), Paris Public Hospital at Home (HAD AP\u2010HP) Greater Paris University Hospitals  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aude","family":"Girault","sequence":"additional","affiliation":[{"name":"Port Royal Maternity Unit, Assistance Publique\u2010H\u00f4pitaux de Paris, H\u00f4pital Cochin FHU Prem'impact  Paris France"},{"name":"Obstetric, Perinatal, Paediatric Life Course Epidemiology Research Team (OPPaLE), Centre for Research in Epidemiology and Statistics (CRESS), Inserm Universit\u00e9 Paris Cit\u00e9  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruna","family":"Perrella","sequence":"additional","affiliation":[{"name":"Department of Neonatal Medicine, FHU Prem'impact, Cochin\u2010Port Royal Hospital, Assistance Publique\u2010H\u00f4pitaux de Paris Cit\u00e9 University  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fran\u00e7ois","family":"Goffinet","sequence":"additional","affiliation":[{"name":"Port Royal Maternity Unit, Assistance Publique\u2010H\u00f4pitaux de Paris, H\u00f4pital Cochin FHU Prem'impact  Paris France"},{"name":"Obstetric, Perinatal, Paediatric Life Course Epidemiology Research Team (OPPaLE), Centre for Research in Epidemiology and Statistics (CRESS), Inserm Universit\u00e9 Paris Cit\u00e9  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Camille","family":"Le Ray","sequence":"additional","affiliation":[{"name":"Port Royal Maternity Unit, Assistance Publique\u2010H\u00f4pitaux de Paris, H\u00f4pital Cochin FHU Prem'impact  Paris France"},{"name":"Obstetric, Perinatal, Paediatric Life Course Epidemiology Research Team (OPPaLE), Centre for Research in Epidemiology and Statistics (CRESS), Inserm Universit\u00e9 Paris Cit\u00e9  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,4,7]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gofs.2018.10.019"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gofs.2018.10.016"},{"issue":"3","key":"e_1_2_12_4_1","article-title":"Planned early birth versus expectant management for women with preterm prelabour rupture of membranes prior to 37\u2009weeks' gestation for improving pregnancy outcome","volume":"3","author":"Bond DM","year":"2017","journal-title":"Cochrane Database Syst 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