K. Hagskog et al., CONSERVATIVE AMBULATORY MANAGEMENT OF PRELABOR RUPTURE OF THE MEMBRANES AT TERM IN NULLIPAROUS WOMEN, Acta obstetricia et gynecologica Scandinavica, 73(10), 1994, pp. 765-769
Objective. To assess maternal and fetal outcome at conservative ambula
tory care of nulliparous women at term with prelabor rupture of the me
mbranes. Methods. A prospective study of 176 women managed conservativ
ely in an ambulatory setting (nonstress test and assessment of amnioti
c fluid index every second day). Results. The median rupture of the me
mbrane to delivery interval was 30 hours. Ninety per cent were deliver
ed within 85 hours. The patients were divided into three groups accord
ing to the time period between rupture of membranes and delivery (unde
r the 25th, 25th-75th and above the 75th centile). The maternal infect
ious morbidity 0, 6, 7% respectively), fetal distress (5, 18, 17% resp
ectively) and instrumental delivery rate (5, 16, 16% respectively) ten
ded to be increased in the upper three quartiles, without reaching a s
tatistically significant level as analysed by chi(2)-test. Nonstress t
est or evaluation of amniotic fluid index was not able to predict intr
apartum fetal distress. In no case was there a delay in the management
of any complication due to the ambulatory care. Conclusion. Awaiting
spontaneous labor in nulliparous women with prelabor rupture of the me
mbranes at term does not seem to be associated with any obvious advant
age. If, however, a conservative attitude is implemented, the patients
can preferably be treated on an ambulatory basis.