DOUBLE-BLIND, PLACEBO-CONTROLLED TRIAL OF PIPERACILLIN PROPHYLAXIS INPRETERM MEMBRANE RUPTURE

OBJECTIVE: We attempted to test whether antibiotic therapy prolongs pr egnancy in preterm premature rupture of membranes, because preterm pre mature rupture of membranes is frequently associated with chorionic-de cidual infection. STUDY DESIGN: Women with preterm premature rupture o f membranes and a singleton gestation at 24 to 34 completed weeks were randomized to receive either piperacillin 3 gm or placebo intravenous ly every 6 hours for 72 hours and were managed conservatively until sp ontaneous delivery, chorioamnionitis, or fetal distress. RESULTS: Betw een January 1987 and January 1992, a total of 75 patients were randomi zed to receive piperacillin (n - 38) or placebo (n 37). There were no differences between the piperacillin group and the placebo group in me an gestational age at randomization (30.2 +/- 3 vs 30.3 +/- 2.9 weeks) . However, a greater number of patients had pregnancy prolonged beyond 7 days (42.1% vs 10.8%, p = 0.005) and the mean latency period was si gnificantly prolonged (11.4 +/- 18 8 vs 6.1 +/- 13.6 days, p = 0.001) in the piperacillin group compared with the control groups. CONCLUSION S: Use of intravenous piperacillin for 72 hours in preterm premature r upture of membranes significantly prolongs the latency period between membrane rupture and delivery.