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Management of Premature Rupture of the Membranes

From the Department of Obstetrics and Gynecology at Truman Medical Center, University of Missouri, Kansas Cily School of Medicine, Kansas City, Missouri.

Abstract

A 14-month prospective study of patients with premature rupture of the membranes was performed. The purpose of the study was to determine the effect of different therapeutic regimens for management of premature rupture of the membranes (PROM) on perinatal morbidity and mortality, as well as on maternal morbidity. Maternal and fetal risk factors and predictive factors in pregnancy outcome were prospectively defined. In patients with PROM whose gestational age was 34 weeks or more, induction within the first 12 hours of membrane rupture resulted in minimal maternal and fetal morbidity and mortality. Patients with gestational age of less than 34 weeks had an improved maternal and fetal outcome if left alone until spontaneous labor or 34 weeks' gestation was reached unless signs of sepsis developed. Respiratory distress syndrome (RDS) was the leading cause of morbidity and mortality in the infants of patients who delivered prematurely due to premature rupture of the membranes. Incidence of fetal infection was significantly less than that of RDS as a cause for fetal morbidity and mortality.

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				M. E. Hannah, A. Ohlsson, D. Farine, S. A. Hewson, E. D. Hodnett, T. L. Myhr, E. E.L. Wang, J. A. Weston, A. R. Willan, and The TermPROM Study Group Induction of Labor Compared with Expectant Management for Prelabor Rupture of the Membranes at Term N. Engl. J. Med., April 18, 1996; 334(16): 1005 - 1010. [Abstract] [Full Text] [PDF]