Ambulation for Latency During Expectant Management of PPROM

Ambulation for Latency During Expectant Management of PPROM: A Randomized Controlled Trial (AMBLE)

Ambulation in pregnancy has been proposed to decrease stress and anxiety, increasing preterm birth. Whether ambulation is causally related to latency is unknown. The FitBit will be used for tracking the number of steps taken daily by each participant, and for encouraging the intervention group to walk. The FitBit is the most widely used physical activity tracker in medical research, and its use has been validated for research use in pregnant women. The purpose of the study is to evaluate whether ambulation in patients with preterm premature rupture of the membranes (PPROM) prolongs latency.

Inclusion Criteria

• Pregnant women aged 12-55
• Gestational age 23 0/7 to 35 0/7 weeks
• PPROM confirmed by clinical diagnosis which includes sterile speculum examination with pooling, ferning, and nitrazine tests, or the Amnisure ROM Test
• Planned inpatient expectant management with delivery goal >=7 days from enrollment
• Ability to provide informed consent in English or Spanish

Exclusion Criteria

• Imminent delivery
• Transverse or footling breech presentation (if multiple gestation, presenting fetus)
• Unstable lie (if multiple gestation, presenting fetus)
• Funic presentation (if multiple gestation, presenting fetus)
• Active vaginal bleeding
• Regular, painful contractions (>=3 in 10 minutes for 30 minutes or more) consistent with labor
• Clinical contraindication to ambulation as determined by the managing physician
• Physician declines to have the patient approached for participation
• Lethal fetal anomalies