A retrospective review of the efficacy and safety of prostaglandin E2 with premature rupture of the membranes at term.
OBJECTIVE
The purpose of this study was to assess rates of endometritis, clinical chorioamnionitis, cesarean delivery, and neonatal sepsis from the records of patients with premature rupture of the membranes (PROM) and an unfavorable cervix treated with vaginal prostaglandin (PG) E2 in comparison with those in the literature.


METHODS
Using a computer data base at Denver General Hospital, we identified 146 women with PROM and cervical dilatation of 2 cm or less at term who were treated with PGE2 gel or suppositories. The records were reviewed to identify rates of maternal and neonatal infection and complications, as well as cesarean delivery.


RESULTS
The cesarean rate was 12%. Chorioamnionitis developed in 6.8% of the study group and endometritis in 2%. Neonatal complications were limited to two with low Apgar scores (less than 7 at 5 minutes), one with microbiologically confirmed sepsis, and two with positive urine counterimmunoelectrophoresis for group B streptococcus. The only instance of neonatal sepsis occurred in a patient with rupture of membranes longer than 24 hours.


CONCLUSIONS
The use of vaginal PGE2 suppositories for induction of labor and cervical ripening in term patients with PROM was accompanied by a high rate of vaginal delivery and a low rate of maternal and neonatal complications in a city hospital setting.
Meikle
S F
SF
Department of Obstetrics and Gynecology, University of Colorado Health Sciences Center, Denver.
Bissell
M E
ME
Freedman
W L
WL
Gibbs
R S
RS
D000282:Administration, Intravaginal; D000328:Adult; D002585:Cesarean Section; D015232:Dinoprostone / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D005322:Premature Rupture of Fetal Membranes; D006801:Humans; D007744:Obstetric Labor Complications; D010120:Oxytocics; D010121:Oxytocin; D011247:Pregnancy; D012189:Retrospective Studies
D010120:Oxytocics; D010121:Oxytocin; D015232:Dinoprostone