Prelabor rupture of membranes at term in low-risk women: induce or wait?

OBJECTIVE

To compare the outcomes of expectant versus induction of labor management of patients presenting with prelabor rupture of membranes (PROM) at term.

STUDY

DESIGN

Observational case-control study over a period of 36 months.

SETTING

King Abdulaziz University Hospital, Jeddah, Saudi Arabia.

SUBJECTS: All obstetric patients with no obstetric risk factors, other than PROMs at term, were included in our study. Each patient was matched with a control case, whose labor started with intact membranes.

OUTCOME MEASURES: Length of labor duration, fetal distress, intrapartum pyrexia, rate of cesarean delivery, and Apgar scores at birth.

RESULTS

The length of labor duration was shorter in patients with PROMs at term compared to the control group, but the difference was not statistically significant. Furthermore, cesarean section (CS) rate was 4.5% in the PROMs group versus 5.5% in the control group. Among patients with PROM who received induction of labor management, the rates of intrapartum pyrexia and CS were almost twice than in patients who were managed expectantly. However, the differences were not statistically significant.

CONCLUSION

In the absence of other obstetric and maternal or fetal risk factors, PROMs at term does not seem to constitute additional obstetric risks. Furthermore, expectant management of PROM at term enhances the patient's chance of normal vaginal delivery without an increase in fetal and/or maternal morbidity.