The project evaluated maternal and newborn outcomes for women who ruptured their membranes before 34 weeks in pregnancy.
A team of Fraser Health colleagues recently published the results of their research in the prestigious International Journal of Gynecology and Obstetrics. Lynne Palmer, Kirsten Grabowska, Jason Burrows, Hilary Rowe and Erin Billing are among the authors of "A retrospective cohort study of hospital versus home care for pregnant women with preterm prelabor rupture of membranes."
Their quality assurance project evaluated maternal and newborn outcomes for women who ruptured their membranes before 34 weeks in pregnancy, comparing those who remained in hospital with those who received care at home.We found that outcomes were similar with both types of management, and that length of stay in hospital was reduced for those who received some of their care at home,” said lead author Lynne Palmer, a perinatal clinical nurse specialist.
Preterm prelabour rupture of membranes (PPROM) is associated with increased risks for mother and baby and requires close monitoring; whether this close surveillance should be in hospital or if these women can be safely monitored at home is controversial.
In Fraser Health, there is an option to refer women with PPROM to the Antepartum Care at Home Program, in which experienced perinatal nurses visit women in their homes for daily assessment. The nurses teach women how to carry out self-assessments and when to return to hospital.
Because the best management strategy is not clear, there is variation in practice, and we hoped to provide local outcome data to support decision making,” said Palmer. "Since our research found that Antepartum Care at Home in Fraser Health is a safe alternative to in-hospital care for women with PPROM who meet strict eligibility criteria, it is possible to reduce length of stay for both mother and newborn, which promotes family centered care and reduces health care utilization.
Palmer has been a nurse for almost 40 years, with Fraser Health for 16. “As a perinatal clinical nurse specialist since 2005, I have had the opportunity to collaborate with amazing practitioners like the team that conducted this quality assurance project. It is extremely rewarding to identify gaps in knowledge and have the support to evaluate an issue as it applies to our population in our resource setting.