A Prospective Study on the Perinatal Outcome in Mozambican Pregnant Women with Preterm Rupture of Membranes Using Two Different Methods of Clinical Management

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Abstract
Antenatal care of women with preterm rupture of membranes is controversial, particularly in countries with high prevalence figures for sexually transmitted diseases and other genital infections. In order to assess the value of conservative and active management routines, 92 women with singleton pregnancies and gestational lengths between 27 and 34 weeks were adopted into the two respective groups. The first group comprised 40 cases who were treated conservatively and the second comprised 52 cases who were treated actively with induction. The first group received amoxicillin (100 mg) and metronidazole (500 mg), both drugs given three times daily. All patients were also routinely treated with an antimalarial dose of chloroquine. The second group was not given any pharmaceutical treatment, and labor was induced 3–24 h after membrane rupture. The two groups differed significantly regarding birth weight, the average birth weights being 2,168 and 1,780 g in the first and second groups, respectively (p < 0.05). While the intrauterine mortality was approximately the same in both groups, the neonatal mortality differed significantly (2.6 vs. 19.2%; p < 0.05). It is concluded that an expectant attitude, rather than an active and induction-oriented one, is most favorable in cases with preterm rupture of membranes, also in settings in which prevalence figures of sexually transmitted diseases and other genital infections are high.

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