Expectant Management of Rupture of Membranes at Term

Wj, Morales; Aj, Lazar

doi:10.1097/00007611-198608000-00010

Cited by 56 publications

(31 citation statements)

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“…This finding also contrasts with those of earlier studies. 6,[14][15][16][17] The centrally controlled approach to randomization (chosen to avoid selection bias), the strict adherence to the treatment protocols in the various treatment groups, and the large number of women evaluated in this study support the conclusion that induction of labor with either intravenous oxytocin or vaginal prostaglandin E 2 gel does not increase the risk of cesarean section, as compared with a practice of expectant management. Women at term with prelabor rupture of the membranes should therefore be reassured that induction of labor is a reasonable option should they prefer this approach.…”

Section: Discussionmentioning

confidence: 79%

Induction of Labor Compared with Expectant Management for Prelabor Rupture of the Membranes at Term

Hannah

Ohlsson

Farine³

et al. 1996

N Engl J Med

464

244

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Section: Discussionmentioning

confidence: 79%

Induction of Labor Compared with Expectant Management for Prelabor Rupture of the Membranes at Term

Hannah

Ohlsson

Farine³

et al. 1996

N Engl J Med

464

244

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“…J. Morales and Lazar AJ 19 have noted that conservative management of patients with premature rupture of membranes at term will significantly decrease the incidence of caesarean section without placing the mother and baby at high risk of high infection. The present study is in agreement with study of J. Morales and Lazar AJ 19 .In present study, 83% of primigravida and 60% of multigravida had spontaneous vaginal delivery in induction group. Whereas, in expectant group 59% of primigravida and 94% of multigravida had spontaneous vaginal delivery.…”

Section: Mode Of Delivery In Relation In Induction Group and Expectanmentioning

confidence: 99%

Induction of Labour Versus Expectant Management for Premature Rupture of Membranes at Term

Bangal

Gulati

Shinde

et al. 2012

Int Jour of Biomed Res

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Background: Premature rupture of the membranes at term is spontaneous rupture of the membranes after 37 wks of the gestations and before the onset of the regular painful uterine contractions .It occurs in ten percent of cases .These cases are either managed conservatively or by immediate induction of labour. Objective: To find out the efficacy and safety of induction of labour versus expectant management in women with premature rupture of membranes beyond 36 weeks gestation, in terms of induction delivery interval, operative interventions, and fetal outcome Material and Methods: A prospective, randomized controlled study was carried out for a period of two years from November 2008 to October 2010 at Rural Medical College, Loni. One hundred pregnant women with term PROM were assigned randomly, each in induction and expectant group. Results: .The mean interval from induction to delivery was significantly shorter in the induction group as compared with expectant group. Incidence of maternal morbidity was comparable in both the groups Neonatal morbidity was higher in expectant group. Incidences of hyper stimulation were more with induction group as compared to expectant group .There was no maternal or perinatal mortality in any group. Intrapartum complications and mode of delivery were similar in both groups. Conclusion: Immediate induction of labour in cases of PROM at term using oral misoprostol resulted in shorter induction delivery interval but increased rate of operative intervention. Maternal morbidity was comparable with induction and expectant line of management. However, neonatal morbidity was higher in expectant group.

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“…The management of prelabour rupture of membranes at term is still a matter of debate, and varies from centre to centre. While active induction of labour soon after prelabour rupture of membranes has resulted in a lower risk of maternal and fetal sepsis in some studies 1–5 , it has also been associated with a higher caesarean section rate in others 6–8 . The largest randomised controlled trial on prelabour rupture of membranes to date 9 found that active labour induction with oxytocin or vaginal prostaglandin E 2 (PGE 2 ) gel, and expectant treatment resulted in similar rates of caesarean sections and neonatal infections, although the risk of maternal infection was lower with oxytocin induction.…”

Section: Introductionmentioning

confidence: 99%

Active management of term prelabour rupture of membranes with oral misoprostol

Shetty

Stewart

et al. 2002

BJOG

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Objective To compare the active management of term prelabour rupture of membranes with oral misoprostol with conservative management for 24 hours followed by induction with oxytocin or prostaglandin E 2 (PGE 2 ) gel. Design A non-blinded randomised controlled trial.Setting Induction and labour wards, Aberdeen Maternity Hospital.Population Sixty-one women with confirmed prelabour rupture of the membranes at ! 36 weeks of gestation.Methods The women were randomised to 50 Ag of oral misoprostol repeated every 4 hours, if required, to a maximum of five doses (active group), or to induction of labour with PGE 2 gel or oxytocin only if not in spontaneous labour 24 hours after prelabour rupture of membranes (conservative group). Main outcome measures Number of women in active labour within 24 hours of the prelabour rupture of membranes, preference of women for any one particular method of management in any subsequent pregnancy with prelabour rupture of membranes. Results 93.3% of the active group and 54.8% of the conservative group were in spontaneous labour within 24 hours of the prelabour rupture of membranes (RR 1.7, 95% CI 1.2 to 2.4). Of those achieving a vaginal delivery, 72% of the active group did so within 24 hours of the prelabour rupture of membranes as compared with 26.9% of the conservative group (RR 2.7, 95% CI 1.4 to 5.3, P ¼ 0.002). There were no significant differences in the neonatal or maternal outcomes. In the active group, 78% felt they would have the same method of induction as compared with 40% in the conservative group (RR 1.9, 95% CI 1.1 to 3.3, P ¼ 0.03). Conclusions Active management with oral misoprostol resulted in more women going into labour and delivering within 24 hours of the prelabour rupture of membranes with no increase in maternal or neonatal complications. Women tended to view active management of prelabour rupture of membranes more positively. Oral misoprostol might be an option to consider in those wishing active management.

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Expectant Management of Rupture of Membranes at Term

Cited by 56 publications

References 0 publications

Induction of Labor Compared with Expectant Management for Prelabor Rupture of the Membranes at Term

Induction of Labor Compared with Expectant Management for Prelabor Rupture of the Membranes at Term

Induction of Labour Versus Expectant Management for Premature Rupture of Membranes at Term

Active management of term prelabour rupture of membranes with oral misoprostol

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