PRELABOR RUPTURE OF MEMBRANES AT TERM - EARLY INDUCTION OF LABOR VERSUS EXPECTANT MANAGEMENT

Objectives: To compare expectant management with early induction of la bour in pregnant patients with prelabour rupture of membranes at term and unfavourable cervix. Study design: A prospective, randomised study of 154 women with prelabour rupture of membranes at term of whom 80 h ad been managed expectantly, and 74 had undergone oxytocin induction a t a rate of 2.5 mU/min. Digital examination was not performed before o xytocin infusion, and the first was delayed until 4 h (nulliparae), or 2 h (multiparae) of regular uterine contractions. Results: The mean p eriod from rupture of membranes to delivery was significantly shorter in the induction group. The mean duration of labour was significantly shorter in the expectant group. Operative vaginal deliveries were more common in the induction group, and fetal distress was the most common cause of operative vaginal deliveries. The caesarean rates were low a nd similar in both groups. Maternal and neonatal infectious morbidity was similar and no difference was found in the length of hospitalisati on. Conclusions: Expectant management in patients with ruptured membra nes at term is safe and reduces the frequency of operative vaginal del iveries. Copyright (C) 1996 Elsevier Science Ireland Ltd.