Outpatient Antibiotics Following Previable Rupture of Membranes (pPPROM) Between 18 0/7 and 22 6/7 Weeks Gestational Age

Exclusion Criteria

• •Gestational dating performed or confirmed by ultrasound at ≥ 18 weeks and 0 days gestational age
• •Patient desires pregnancy interruption or induction of labor
• •Known major fetal anomaly or aneuploidy
• •Amniocentesis ≤ 7 days of diagnosis of rupture of membranes
• •Cervical cerclage placement ≤ 7 days of diagnosis of rupture of membranes
• •Known drug allergy or significant adverse reactions to macrolide or penicillin antibiotics
• •Current antibiotic use at the time of membrane rupture diagnosis
• •Vaginal bleeding at the time of membrane rupture diagnosis or within first 24 hours from diagnosis
• •Febrile at the time of membrane rupture diagnosis (i.e., temperature ≥ 38 degrees Celsius) and/or within first 24 hours of diagnosis
• •Active preterm labor at the time of membrane rupture diagnosis (i.e., consistent contraction pattern associated with cervical change) and/or within first 24 hours of diagnosis
• •Cervical dilation of ≥ 4 cm
• •Prolapse of fetal parts beyond the level of the internal cervical os
• •Declination to complete full, 7-day outpatient monitoring prior to hospital re-admission should rupture occur during the 22nd week of gestation