MANAGEMENT OF PRELABOR RUPTURE OF MEMBRANES AT TERM - A RANDOMIZED STUDY

Objective. To compare the rate of obstetric interventions, length of l abor, and maternal morbidity in pregnancies with prelabor rupture of m embranes at term after either early or late induction of labor in both primiparous and pluriparous women. Design. Prospective, randomized st udy. Subjects. 362 women with singleton pregnancies, cephalic presenta tions, gestational age of 36 completed weeks or more were allocated at random to induction with oxytocin either 6 hours after PROM (n = 62) (early) or 24 hours (n = 62) (late). Those eligible, but not participa ting in the study, totalled 238 women. Main obstetric measures. Time o f spontaneous labor in the late induction group, length of labor, obst etric intervention rate, maternal morbidity, and the degree of histolo gic chorioamnionitis. Results. The length of labor was longer in the l ate induction group than in the early induction group in both primipar ous and pluriparous (p<0.05). There were no overall differences in the rate of obstetric interventions or maternal morbidity, but there were marked differences between primiparous and pluriparous women. Increas ing time span between the period from rupture of membranes to delivery increased the degree of histologic chorioamnionitis. Conclusion. If a woman wants a short labor, she will benefit from early induction. We did not find statistical differences in the rate of obstetric interven tion or in the maternal morbidity, but there was a tendency towards ad verse effects of late induction.