CONSERVATIVE MANAGEMENT OF PATIENTS WITH PREMATURE RUPTURE OF FETAL MEMBRANES

  • 1 January 1982
    • journal article
    • research article
    • Vol. 59  (5) , 607-610
Abstract
Management of pregnant patients with premature rupture of membranes (PROM) prior to 32 wk gestation or at 32-34 wk gestation is controversial. In a retrospective analysis of 109 patients with PROM at or prior to 34 wk gestation, 53 (49%) were managed conservatively and labor was either induced or occurred spontaneously within 24 h in 56 (51%). Patients initially presenting with chorioamnionitis were excluded from this study, as were all patients with evidence of a fetal anomaly or a medical indication for delivery. The 53 patients managed conservatively had a mean pregnancy prolongation of 21 days (2-105 days; median 7 days). The infants of patients managed conservatively had a lower incidence of respiratory distress syndrome (P < 0.0025), mortality (P < 0.05) and intracranial hemorrhage (P < 0.03). Sixty-four percent of the conservatively managed group vs. 45% of the induced/spontaneous labor group were normal upon physical and neurologic examination when discharged from the hospital (P < 0.035). The difference in incidence of neonatal sepsis between these 2 groups was not statistically significant (P = 0.42). Immediate induction of labor and/or delivery for patients with PROM at < 32 wk gestation resulted in a significant increase in perinatal mortality and morbidity.