Prelabour rupture of membranes at term: early induction of labour versus expectant management.
OBJECTIVE
To compare expectant management with early induction of labour in pregnant patients with prelabour rupture of membranes at term and unfavourable cervix.


METHODS
A prospective, randomised study of 154 women with prelabour rupture of membranes at term of whom 80 had been managed expectantly, and 74 had undergone oxytocin induction at a rate of 2.5 mU/min. Digital examination was not performed before oxytocin infusion, and the first was delayed until 4 h (nulliparae), or 2 h (multiparae) of regular uterine contractions.


RESULTS
The mean period from rupture of membranes to delivery was significantly shorter in the induction group. The mean duration of labour was significantly shorter in the expectant group. Operative vaginal deliveries were more common in the induction group, and fetal distress was the most common cause of operative vaginal deliveries. The caesarean rates were low and similar in both groups. Maternal and neonatal infectious morbidity was similar and no difference was found in the length of hospitalisation.


CONCLUSIONS
Expectant management in patients with ruptured membranes at term is safe and reduces the frequency of operative vaginal deliveries.
Alcalay
M
M
Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel Hashomer, Israel.
Hourvitz
A
A
Reichman
B
B
Luski
A
A
Quint
J
J
Barkai
G
G
Mashiach
S
S
Lipitz
S
S
D000328:Adult; D002585:Cesarean Section; D005260:Female; D005316:Fetal Distress; D005322:Premature Rupture of Fetal Membranes / Q000628:therapy*; D006801:Humans; D007231:Infant, Newborn; D007751:Labor, Induced; D010121:Oxytocin / Q000627:therapeutic use; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies
D010121:Oxytocin