Preterm premature rupture of membranes ( XXXX ): outcomes of delivery at 32(  /7) -33(6/7) weeks after confirmed fetal lung maturity (FLM) versus expectant management until 34(  /7) weeks.

@entity1 @entity3166 @entity295 @entity548 @entity7288 @entity2209 @entity649 @entity5870 @entity5869 @entity281 @entity13493 @entity3634
OBJECTIVE: Our objective was to compare maternal and neonatal outcomes in @entity1 with @entity13493 ( @entity13493 ) delivered prior to 34(  /7) weeks upon confirmation of fetal lung maturity (FLM) to those managed expectantly until 34(  /7) weeks. METHODS: We performed a retrospective cohort study of non-anomalous singleton gestations with @entity13493 occurring after 24 weeks delivered between 32(  /7) and 34(  /7) weeks from 2004 to 2012. @entity1 delivered upon documented FLM (+FLM) - defined as the presence of @entity3634 (PG) at 32(  /7)-33(6/7) weeks if amniotic fluid was obtainable vaginally - were compared with @entity1 delivered without documented FLM between 32(  /7) and 34(  /7) weeks (expectant). Primary outcomes included @entity281 (clinically diagnosed @entity7288 or @entity5870 ), @entity5869 and a composite of neonatal morbidities (including but not limited to mechanical ventilation, @entity548 , @entity3166 , @entity295 and @entity649 ). Statistical analysis was performed using Student's t-test for continuous variables and Chi-square or Fisher's exact test for categorical data. Covariates were analyzed via multivariate logistic regression and adjusted odds ratios were calculated. RESULTS: Of 237 PPROMs delivered at 32(  /7)-34(  /7) weeks, 74 were intentionally delivered for +FLM and 163 were expectantly managed. No cord prolapse or @entity2209 was observed. @entity281 ( @entity5870 or @entity7288 ) was lower in the +FLM group (aOR 0.33 95% CI 0.12-0.88). Overall, there was no difference in composite neonatal morbidity did not differ between the two groups (aOR 1.36 95% CI 0.53-3.54). CONCLUSIONS: In @entity1 with @entity13493 , delivery after confirmation of FLM at 32(  /7)-33(6/7) weeks compared with expectant management until 34(  /7) weeks may prevent @entity281 without increasing neonatal morbidity.
