title: Controlled comparison of induction versus expectant care for prelabor rupture of the membranes at term.
abstract: This randomized clinical trial compared oxytocin induction of labor with expectant care for 48 hours after prelabor rupture of the membranes at term. Women at term with prelabor rupture of the membranes for at least 8 hours were assigned at random to induction with oxytocin or to expectant management for 48 hours followed by induction if necessary. Of 168 eligible women, 123 (73%) agreed to participate. More women in the induction group (23%) than in the expectant group (10%) had operative delivery, either cesarean section or instrumental vaginal delivery. In the induction group 41% received analgesia versus 24% in the expectant group (p < 0.005). There was no difference in the rate of maternal and neonatal infection between groups and sepsis was not observed. The active policy of oxytocin induction exposed the mother to a higher risk of operative delivery and a less comfortable labor than the 48 hours expectant care option.
authors.affiliation: Department of Obstetrics and Gynecology, Leyenburg Hospital, The Hague, The Netherlands.
authors.forename: H P
authors.initials: HP
authors.lastname: Ottervanger
authors.forename: M J
authors.initials: MJ
authors.lastname: Keirse
authors.forename: W
authors.initials: W
authors.lastname: Smit
authors.forename: J P
authors.initials: JP
authors.lastname: Holm
mesh_terms: D016362:Analgesia, Obstetrical / Q000706:statistics & numerical data; D002584:Cervix Uteri / Q000382:microbiology; D002585:Cesarean Section / Q000706:statistics & numerical data; D005113:Extraction, Obstetrical / Q000706:statistics & numerical data; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000628:therapy*; D006801:Humans; D007745:Labor Onset; D007751:Labor, Induced; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D011256:Pregnancy Outcome