title: Pre-labor rupture of membranes at term in patients with an unfavorable cervix: active versus conservative management.
abstract: OBJECTIVE
  To compare the safety and efficacy of conservative management of pre-labor rupture of membranes (PROM) at term in patients with an unfavorable cervix, with active treatment using oral misoprostol.
  
  
  METHODS
  This quasi-experimental study was conducted between June 1, 2004 and November 30, 2004 at Bahawal Victoria Hospital, Bahawalpur, Pakistan. Eighty-four multigravid women (parity, < 5) at > or = 37 weeks' gestation and with unfavorable cervices were divided equally between group S (study) and group C (conservative). Group S was given 50 micrograms of oral misoprostol every 4 hours for a maximum of four doses, while group C was managed conservatively. The intervals between PROM and significant uterine contractions and delivery, the mode of delivery, and maternal and fetal/neonatal complications were the main outcome measures.
  
  
  RESULTS
  The intervals between PROM and the onset of uterine contractions and delivery were lower in group S than group C (9.6 vs. 14.8 hours; p < 0.001) and (11.6 vs. 17 hours; p < 0.001), respectively. Fewer women delivered abdominally within 24 hours of PROM in group S than in group C (5% vs. 24%; p < 0.05). Induction failure in group S was less than conservative management failure in group C (10% vs. 60%; p < 0.001). The maternal complication rate was less in group S than in group C (7% vs. 14%; p > 0.05), but the fetal/neonatal complication rate was similar in both groups (5%).
  
  
  CONCLUSIONS
  Oral misoprostol (50 micrograms) is safe and effective for cervical ripening and labor induction in patients with PROM and an unfavorable cervix.
authors.affiliation: Hera General Hospital, Makkah, Saudi Arabia.
authors.forename: Aqueela
authors.initials: A
authors.lastname: Ayaz
authors.forename: Shazia
authors.initials: S
authors.lastname: Saeed
authors.forename: Mian Usman
authors.initials: MU
authors.lastname: Farooq
authors.forename: Fayaz
authors.initials: F
authors.lastname: Ahmad
authors.forename: Luqman Ali
authors.initials: LA
authors.lastname: Bahoo
authors.forename: Iftikhar
authors.initials: I
authors.lastname: Ahmad
mesh_terms: D000328:Adult; D020070:Cervical Ripening / Q000187:drug effects; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000628:therapy*; D006801:Humans; D007751:Labor, Induced / Q000379:methods*; D016595:Misoprostol / Q000008:administration & dosage*; D010120:Oxytocics / Q000008:administration & dosage*; D011247:Pregnancy; D016896:Treatment Outcome
chemical_list: D010120:Oxytocics; D016595:Misoprostol