Controversies: premature rupture of membranes at term--no advantage of delaying induction > 24 hours.

Results from randomised trials with formal randomisation indicate no evidence of benefits in terms of cesarean delivery of maternal/neonatal infectious morbidity by awaiting spontaneous onset of labor for more than 24 hours in women with term PROM. An overnight policy of management seems to be an attractive alternative to other management protocols. Women with prelabor rupture of membranes await stimulation of labor with oxytocin till next morning if admitted before midnight. A majority of the women may go into spontaneous labor with an excellent prospect of having a vaginal delivery. Particularly the nulliparous woman with poor cervical score could benefit from such an approach. Although prostaglandins in theory should be an useful adjunct agent to oxytocin, particularly in the nulliparous woman with unripe cervix, convincing evidence of the efficacy of the drug is still lacking. Well-conducted and randomised studies to evaluate the role of prostaglandins in nulliparous women with PROM are required.