HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by WAGNER, M. V. Articles by NEWMAN, L. A. Search for Related Content PubMed PubMed Citation Articles by WAGNER, M. V. Articles by NEWMAN, L. A.

A Comparison of Early and Delayed Induction of Labor With Spontaneous Rupture of Membranes at Term

From the Department of Obstetrics and Gynecology, Kaiser Permanente Medical Center, Oakland, California

Abstract

The management of women with spontaneous rupture of membranes at term in the absence of labor and with a cervix unfavorable for induction of labor is controversial. In this randomized study of 182 patients, we report the effects of delayed versus early induction of labor on maternal and neonatal outcome. Qualifying patients not in labor at 6 hours after spontaneous rupture of membranes were randomized to either immediate oxytocin induction (86 women) or expectant management with oxytocin induction at 24 hours if labor had not occurred spontaneously (96 women). The cesarean section rate did not differ between the two groups. Women in the delayed group had significantly longer hospitalization (P < .003), and their infants were significantly more likely to receive antibiotics (P = .006). Infectious morbidity (positive cultures or x-ray-documented pneumonia) occurred in five of the neonates in the delayed group, all of whose mothers had an initial digital cervical examination, but in none of the neonates in the early group, a difference that did not reach statistical significance (P = .061). Five (28%) of 18 infants from the delayed group whose mothers had received an initial digital cervical examination became infected, compared with none of the 78 infants from the delayed group whose mothers did not have digital examinations (P < .001). We conclude that there is no advantage to delaying induction of labor when women present at term with spontaneous rupture of membranes.

This article has been cited by other articles:

				D. PELEG, M. E. HANNAH, E. D. HODNETT, G. A. FOSTER, A. R. WILLAN, and D. FARINE Predictors of Cesarean Delivery After Prelabor Rupture of Membranes at Term Obstet. Gynecol., June 1, 1999; 93(6): 1031 - 1035. [Abstract] [Full Text] [PDF]

				M. C. Ennis, M. P. Geary, J. J. Morrison, J. L. Ecker, S. J. Kilpatrick, M. E. Hannah, and P. Duff Prelabor Rupture of the Membranes at Term N. Engl. J. Med., October 10, 1996; 335(15): 1156 - 1159. [Full Text]

				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]

				P. Duff Premature Rupture of the Membranes at Term N. Engl. J. Med., April 18, 1996; 334(16): 1053 - 1054. [Full Text]