ADMINISTRATION OF ANTIBIOTICS TO PATIENTS WITH RUPTURE OF MEMBRANES AT TERM - A PROSPECTIVE, RANDOMIZED, MULTICENTRIC STUDY

Objective. To assess whether antibiotic administration changes the rat e of materno-fetal infectious morbidity in premature rupture of membra nes occurring later than 35 weeks of gestation. Methods. A prospective , randomized and multicentric study in the Perinatology Units of eleve n hospitals in Spain. Women were randomized to either antibiotic admin istration or control group. All were induced, if labor had not started spontaneously after 12 hours of ruptured membranes. Main outcome meas ures were maternal infection (chorioamnionitis and endometritis) and n eonatal infectious morbidity (neonatal sepsis, meningitis and bronchop neumonia). Results. Seven hundred and thirty-three patients were enrol led in the study, 371 in the antibiotics group and 362 in the control group. The incidence of chorioamnionitis and puerperal endometritis we re reduced but the differences are statistically nonsignificant. Howev er, the incidence of neonatal sepsis was significantly lower in newbor ns to mothers who had received antibiotics, 1 vs. 7 cases (Fisher's ex act test, p<0.007). Conclusion. The study strongly suggests that proph ylactic use of antibiotics in premature rupture of membranes occurring at 36 or more weeks of gestation reduces the risk of neonatal sepsis and probably maternal endometritis.