title: Premature rupture of the membranes at term. Obstetric outcome with oxytocin stimulation in relation to parity and cervical dilatation at admission.
abstract: The obstetric outcome in women with premature rupture of the membranes (PROM) at term (greater than 36 weeks gestation) without spontaneous onset of labor (within 2 h after admission) was evaluated prospectively in a joint study at the University Hospital of Lund, Sweden and Kandang Kerbau Hospital, National University of Singapore. After 2 h of observation without uterine contractions, labor was stimulated with oxytocin infusion. 303 patients participated and were classified according to parity (nulliparae-multiparae) and cervical dilatation at admission (less than 2 cm dilated; greater than or equal to 2 cm dilated). No significant race-related differences could be found, except for birthweight. Nulliparae with unfavorable cervix at admission had a high rate of ominous fetal heart rate findings in labor and a high cesarean section rate (19.4%), particularly for failed stimulation of labor. The high cesarean section rate after routine stimulation of labor in nulliparae with unfavorable cervix suggests that a non-intervention approach may be justified in this group. In contrast, the cesarean section rate after stimulation of labor was 3.6% in nulliparae with the cervix dilated 2 cm or more at admission and 4.2% in multiparae and ominous fetal heart rate changes were much less common.
mesh_terms: D000328:Adult; D001034:Apgar Score; D002584:Cervix Uteri / Q000502:physiology; D002585:Cesarean Section; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000175:diagnosis / Q000628:therapy*; D006340:Heart Rate, Fetal; D006801:Humans; D007231:Infant, Newborn; D007751:Labor, Induced; D010121:Oxytocin / Q000008:administration & dosage*; D010298:Parity; D011247:Pregnancy; D011379:Prognosis; D011446:Prospective Studies; D014590:Uterine Contraction / Q000187:drug effects
chemical_list: D010121:Oxytocin