MANAGEMENT OF PREMATURE RUPTURE OF THE ME MBRANES IN OBSTETRIC DEPARTMENTS IN GERMANY

Since the treatment of premature ruptures of membranes is not only con troversial in the German hut also in the international literature, we performed a survey of all obstetrics departments in Germany. From a to tal 843 hospitals, 444 questionnaires were returned for evaluation (52 .7%). The purpose was to determine which diagnostic and therapeutic re gimes are used and how these agree with the literature. In addition to questions on the type of hospital. birth rates with a percentage of p remature births and applied diagnostic parameters, our special interes t focused on therapy, particularly with regard to prophylactic antibio tic application, tocolytic treat ment and lung maturity induction. Pro phylactic antibiotics are used in 36.7% and prophylactic tocolytic the rapy in 41.7% of the departments. Interestingly, lung maturity inducti on was performed in 93.5%, in part even before the 28th week of pregna ncy, although the effect of this therapy has not yet been proven of a very early stage of gestation. Due to the different views In the liter ature and, in part, a lack of basic scientific data, it seems that in the majority of hospitals there is a presence for tbe procedure, in wh ich the best personal experience has been made. Because premature rupt ures of the membranes is responsible for 30-40 of premature births, it is urgently necessary to clarify this controversial problem by large multicenter studies so that the treatment of early premature ruptures of the amnion can be founded on a rational basis.