Premature rupture of membranes at 34 to 37 weeks' gestation: Aggressive versus conservative management

Abstract

OBJECTIVE: Our purpose was to compare induction of labor with preterm rupture of membranes between 34 and 37 weeks' gestation with expectant management. STUDY DESIGN: In this prospective investigation 120 gravid women at ≥34 weeks 0 days and <36 weeks 6 days of gestation were randomized to receive oxytocin induction ( n = 57) or observation ( n = 63). RESULTS: Estimated gestational age at rupture of membranes (34.3 ± 1.4 weeks vs 34.5 ± 1.4 weeks) and ultrasonographically estimated fetal weight (2230 ± 321 gm vs 2297 ± 365 gm) were equivalent between groups (not significant). Chorioamnionitis occurred more often (16% vs 2%, p = 0.007), and maternal hospital stay (5.2 ± 6.8 days vs 2.6 ± 1.6 days, p = 0.006) was significantly longer in the control group. Neonatal sepsis was also more common in the observation group ( n = 3) than among induction patients ( n = 0), but the difference was not statistically significant. CONCLUSIONS: Aggressive management of preterm premature rupture of the membranes at ≥34 weeks 0 days of gestation by induction of labor is safe for the infant in our population and avoids maternal-neonatal infectious complications. (Am J Obstet Gynecol 1998;178:126-30.)