Pre-labor rupture of membranes at term in patients with an unfavorable cervix: active versus conservative management.
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.
Ayaz
Aqueela
A
Hera General Hospital, Makkah, Saudi Arabia.
Saeed
Shazia
S
Farooq
Mian Usman
MU
Ahmad
Fayaz
F
Bahoo
Luqman Ali
LA
Ahmad
Iftikhar
I
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
D010120:Oxytocics; D016595:Misoprostol