PREMATURE RUPTURE OF MEMBRANES AT 34 TO 37 WEEKS GESTATION - AGGRESSIVE VERSUS CONSERVATIVE MANAGEMENT

OBJECTIVE: Our purpose was to compare induction of labor with preterm rupture of membranes between 34 and 37 weeks' gestation with expectant management. STUDY DESIGN: In this prospective investigation 120 gravi d women at greater than or equal to 34 weeks 0 days and <36 weeks 6 da ys of gestation were randomized to receive oxytocin induction (n = 57) or observation (n = 63). RESULTS: Estimated gestational age at ruptur e of membranes (34.3 +/- 1.4 weeks vs 34.5 +/- 1.4 weeks) and ultrason ographically estimated fetal weight (2230 +/- 321 gm vs 2297 +/- 365 g m) were equivalent between groups (not significant). Chorioamnionitis occurred more often (16% vs 2%, p = 0.007), and maternal hospital stay (5.2 +/- 6.8 days vs 2.6 +/- 1.6 days, p = 0.006) was significantly l onger in the control group. Neonatal sepsis was also more common in th e observation group (n = 3) than among induction patients (n = 0), but the difference was not statistically significant. CONCLUSION: Aggress ive management of preterm premature rupture of the membranes at greate r than or equal to 34 weeks 0 days of gestation by induction of labor is safe for the infant in our population and avoids maternal-neonatal infectious complications.