DIFFERENCES IN NEONATAL MORBIDITY DEPENDING ON INDUCTION OF LABOR AFTER PREMATURE RUPTURE OF MEMBRANES

Over a period of about six months each, deliveries after premature rup ture of membranes (FROM) and a confirmed gestational age of > 32 weeks were subjected to either of the following regimes: During the first 6 months induction was started 48 hours after FROM in the absence of sp ontaneous labour (Group 1). During the following 6 months labour was i nduced 12 hours after FROM in case of lacking labour-dependent cervica l dilatation (Group 2). Progress of delivery and neonatal morbidity we re analysed in both groups. 7.6% of the deliveries had to be induced i n Group 1 compared with 25.7% in Group 2. No significant difference in the delivery rate after 48 hours and in the operative delivery rate c ould be observed (88.9% vs. 94.6% and 28.5% vs. 30.1%). Comparing both subgroups, which underwent induction, revealed an increased operative delivery rate in Group 2 (42% vs. 33%). The period of labour in this group was prolonged (15 hours vs 9 hours). Caesarean section because o f an amnionic infection syndrome and transfer to the neonatal care uni t were not found to be different in groups 1 and 2 as well as in the c orresponding subgroups. Severe infections such as pneumonia or amnioni c infection syndrome were observed in 3.8% (Group 1) and in 5.7% (Grou p 2). 7.4% of the newborn, delivered after induction of labour 12 hour s following FROM, developed these infections, whereas no case arose wh en labour was induced after 48 hours. These data suggest no benefit fo r newborn delivered after induction of labour 12 hours following FROM, compared to newborn delivered after an expectant labour by induction after 48 hours.