title: [Active management of the premature membrane rupture in pregnancies of 34 to 37 weeks].
abstract: BACKGROUND
  Premature rupture of membranes is considered an obstetrical emergency since it has been associated with an increment of sepsis and maternal-fetal morbidity. For this reason, controversy exists among conservative and active management for the obstetrical resolution.
  
  
  OBJECTIVE
  To determine if active management of premature rupture of membranes in pregnancy of 34 to 37 weeks diminishes the cesarean section incidence and the maternal-fetal morbidity.
  
  
  METHODS
  Two groups of patients with pregnancy of 34 to 37 weeks and premature rupture of membranes were compared. Group I with active management was integrated by 42 cases that initiated inductoconduction at their admission to the hospital, and in group II, with 26 cases on the conservative management, medication was used to induce fetal pulmonary maturity and spontaneous delivery was expected. Descriptive statistics was carried out by means of the statistical package SPSS-10.
  
  
  RESULTS
  The mean age of the patients was 27.2 +/- 5.8 years. Pregnancy resolution within the first 12 hours was 23.8% in group I and 11.5% in group II. Cesarean section in group I was made in 28.5% of the cases and in group II in 65.3% of them (p < 0.05). The most common indication for cesarean section in group I was stationary labor (16.5%) and in group II unfavorable cervical conditions (26.9%). Maternal and newborn hospital stay was greater in group II (p < 0.01). The most frequent maternal complication in both groups was decidual infection, with 4.7 and 15.3%, respectively. General maternal and neonatal morbidity was greater in group II.
  
  
  CONCLUSIONS
  Conservative management of premature rupture of membranes, when pregnancy is equal or greater than 34 weeks, does not offer fetal benefits, increases the incidence of cesarean sections, the hospital stay and the cost of the medical attention.
authors.affiliation: Departamento Clínico de Perinatología, Hospital de Ginecología y Obstetricia Numero 3.
authors.forename: Maria Guadalupe
authors.initials: MG
authors.lastname: Veloz Martínez
authors.forename: Jorge
authors.initials: J
authors.lastname: Bolaños Baños
authors.forename: María de los Angeles
authors.initials: Mde L
authors.lastname: Guzmán Ibarra
authors.forename: Oscar Arturo
authors.initials: OA
authors.lastname: Martínez Rodríguez
authors.forename: José Antonio
authors.initials: JA
authors.lastname: Páez Angulo
authors.forename: Marcelino
authors.initials: M
authors.lastname: Hernández Valencia
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000628:therapy*; D006801:Humans; D011247:Pregnancy; D011263:Pregnancy Trimester, Third