Premature rupture of membranes at term with an unfavorable cervix: comparison of expectant management, vaginal prostaglandin, and oxytocin induction.
BACKGROUND
Our objective was to determine the best treatment for parturients at term with an unfavorable cervix and premature rupture of membranes (PROM).


METHODS
In this prospective study, 96 women with PROM and an unfavorable cervix were randomized into one of three treatment groups: oxytocin induction, vaginal prostaglandin E2 gel followed by oxytocin, or expectant management.


RESULTS
Length of labor, cesarean section rate, and maternal/neonatal morbidity were not significantly different. In contrast, the interval from PROM until delivery and length of hospital stay were significantly longer in the expectantly managed group than in the other groups. Four of the patients who received expectant management required delivery because of nonreassuring fetal assessments.


CONCLUSIONS
Expectant management of PROM at term significantly prolongs hospital stay without decreasing the incidence of abdominal delivery or infectious morbidity. There appears to be potential for cord compression in patients managed expectantly without continuous electronic fetal surveillance.
McCaul
J F
JF
Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson 39216-4505, USA.
Rogers
L W
LW
Perry
K G
KG
Martin
R W
RW
Allbert
J R
JR
Morrison
J C
JC
D002585:Cesarean Section; D015232:Dinoprostone / Q000627:therapeutic use*; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000628:therapy*; D006801:Humans; D007743:Labor, Obstetric; D007902:Length of Stay; D010120:Oxytocics / Q000627:therapeutic use*; D010121:Oxytocin / Q000627:therapeutic use*; D011247:Pregnancy; D011446:Prospective Studies; D013997:Time Factors
D010120:Oxytocics; D010121:Oxytocin; D015232:Dinoprostone