Double-blind study of premature rupture of the membranes: A report of 1,896 cases

Abstract

1. A multihospital study involving 18 United States Naval Hospitals was conducted to ascertain whether a prophylactic antibiotic administered to expectant mothers with premature rupture of membranes would decrease the perinatal mortality. A double-blind protocol was followed in administering the drug and placebo to the expectant mothers.2. Of 25,427 patients delivered, 2,934 or 11.5 per cent had premature rupture of membranes.3. About 1 in every 5 infants delivered to mothers with premature rupture of membranes were either premature or immature.4. Demethylchlortetracycline does not affect the perinatal mortality of infants of mothers with premature rupture of membranes. This also held true when latent period of mother and maturity of infant was held constant.5. Perinatal mortality, by reason of infection, accounted for about 1 in every 4 perinatal deaths in the study. Demethylchlortetracycline does not affect perinatal mortality by reason of sepsis, when given to the mother ante partum and intra partum.6. Demethylchlortetracycline does, however, lower postpartum morbidity when it is given ante partum, intra partum, and post partum, 150 mg. 2 times a day.7. The decrease in postpartum morbidity is a function of both decreased incidence of endometritis and parametritis, and postpartum pyelonephritis.8. Premature rupture of the membranes deserves further study from the standpoint of induction of labor in an attempt to lower fetal wastage by reason of sepsis.