[Administration of prostaglandin E2 in premature rupture of the membranes].

The imminent amnion infection syndrome with or without premature rupture of the membranes is regarded as one of the most severe perinatal complications, especially for the baby. Early treatment or better, prevention of manifest intrauterine infection syndrome is thus a priority task in obstetrics. In recent years, administration of prostaglandin has proven to be a good choice to stimulate cervix maturation and to induce labor. The present study wanted to investigate the effect of prostaglandin application in PRM. Prostaglandin E2 was intracervically applied in the form of gel, and intravaginally in the form of a tablet. Its action was compared with controls. Patients with immature cervix were evaluated versus patients with mature cervix. Duration of labor and fetal outcome were compared to a group of non-primed patients. After application of prostaglandin E2, approximately 80% of patients started to deliver within 24 hours. Concerning the duration of labor, the rate of cesareans, incipient chorio-amnionitis and fetal morbidity, independent of cervical maturation, results after prostaglandin E2 administration were better among the primi- and pluriparae. Adverse effects such as uterine overstimulation or pathologic FHF in the CTG were seen in 7% of the cases. The incidence of pH-shifting in the umbilical artery was nearly equal in all groups. Our study confirmed that prostaglandin E2-application constitutes a successful method to shorten aminon infection syndrome. In absence of spontaneous labor, priming should be done early, e.g. within six to seven hours.