Ls. Sperling et al., MANAGEMENT OF PRELABOR RUPTURE OF MEMBRANES AT TERM - A RANDOMIZED STUDY, Acta obstetricia et gynecologica Scandinavica, 72(8), 1993, pp. 627-632
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.