The impact of clinical management type on maternal and neo-natal outcome following pre-labour rupture of membranes at term

Abstract

To investigate the impact of home compared to hospital conservative management on maternal and neonatal outcome on women with pre-labour rupture of membranes (PROM) at term. A randomised, controlled trial, participants were randomly allocated to one of the following two arms of clinical intervention, hospital management group (N = 27) or home management group (N = 29). The dependent variables were established clinical indices of maternal and neonatal outcome. 56 women admitted to the maternity unit of a north east England maternity hospital with confirmed PROM. All participants were over 37 weeks gestation (mean 39.08, SD 1.08), with a singleton pregnancy of cephalic presentation and no apparent medical or obstetric contra-indications and absence of uterine contractions. No significant differences were found between groups in maternal high vaginal swab infection rates, neonatal infection screen or Apgar scores. No other statistically significant differences between groups were observed on any of the key clinical outcome maternal or neonatal indices. This study provides empirical evidence that women allowed home for the period of expectant management are at no greater risk from adverse maternal or neonatal outcomes than their counterparts who remained in hospital. This has important clinical implications for the management of PROM at term. The direction of future research in this area is indicated.