Expectant management of spontaneous rupture of membranes at term

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Abstract
The outcome of expectant management of spontaneous rupture of membranes involving postponement of oxytocin induction for at least 24 hours was assessed in 1285 patients who presented after 37 weeks of pregnancy. All but 88 (6.8 per cent) laboured spontaneously within 24 hours. Labour was induced with oxytocin in 41 of 88 mothers with prolonged rupture of membranes and four were delivered by caesarean section. Prolonged rupture of membranes was commoner among primiparae, as were operative delivery and the duration of oxytocin induction (when used). Vaginal clusters at delivery grew pathogens in 59 (67 per cent) mothers but only three needed antibiotics. Neonatal cultures were positive in 16 babies (18 per cent); five were given antibiotics and none suffered significant morbidity. There was one perinatal death associated with caesarean scar dehiscence. Postponement of oxytocin induction for 24-48 hours following spontaneous rupture of the membranes at term reduced obstetric intervention without a concomitant increase in infectious morbidity in mothers or babies.

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