title: Misoprostol versus expectant management in premature rupture of membranes at term.
abstract: OBJECTIVE
  To compare the effectiveness of immediate induction of labour with vaginal misoprostol versus expectant management for 24 hours followed by oxytocin induction in women with premature rupture of membranes at term (term PROM).
  
  
  METHODS
  An open, randomised, controlled trial.
  
  
  METHODS
  Public university hospital in Campinas City, Brazil.
  
  
  METHODS
  One hundred and fifty pregnancies, half of them allocated to each group.
  
  
  METHODS
  Statistical analysis used Student's t test, the chi2 test, Fisher's exact test, survival analysis and risk ratio estimates with 95% CI.
  
  
  METHODS
  Latency period, recruitment to delivery period, period of hospitalisation, mode of delivery, contractility pattern, fetal wellbeing, labour and delivery complications, neonatal and maternal morbidity.
  
  
  RESULTS
  Both groups had similar general characteristics, but the misoprostol group had a significantly shorter latency period (9.4 vs 15.8 hours), a shorter time interval from recruitment to delivery (18.9 vs 27.5 hours), a shorter period of maternal hospitalisation and a slightly higher proportion of alterations of contractility when compared with the expectant group. Caesarean section rates were 20% in the misoprostol group and 30.7% in the other. There were no differences between them regarding fetal wellbeing, complications during labour and delivery and neonatal or postpartum maternal morbidity. Within 24 hours, 44% of women had delivered in the expectant group against 73.3% in the misoprostol group.
  
  
  CONCLUSIONS
  Immediate labour induction with misoprostol in cases of term PROM shortens the latency period, the total time between recruitment to delivery and the time of maternal hospitalisation, increasing the occurrence of alterations of contractility without any maternal and perinatal outcomes disadvantages.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medical Sciences, Universidade Estadual de Campinas-UNICAMP, Campinas, São Paulo, Brazil.
authors.forename: Fabiana
authors.initials: F
authors.lastname: da Graça Krupa
authors.forename: José Guilherme
authors.initials: JG
authors.lastname: Cecatti
authors.forename: Fernanda Garanhani
authors.initials: FG
authors.lastname: de Castro Surita
authors.forename: Helaine Maria Besteti Pires
authors.initials: HM
authors.lastname: Milanez
authors.forename: Mary Angela
authors.initials: MA
authors.lastname: Parpinelli
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal; D000293:Adolescent; D000328:Adult; D001034:Apgar Score; D002585:Cesarean Section; D005260:Female; D005322:Premature Rupture of Fetal Membranes; D006801:Humans; D007751:Labor, Induced / Q000379:methods*; D007902:Length of Stay; D016595:Misoprostol; D009200:Myocardial Contraction / Q000187:drug effects; D011247:Pregnancy; D011256:Pregnancy Outcome; D012307:Risk Factors; D013607:Tablets
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D013607:Tablets; D016595:Misoprostol