A randomized trial of management of pre-labor rupture of membranes at term in multiparous women using vaginal prostaglandin gel.

Abstract

OBJECTIVE:

To compare conservative management of pre-labor spontaneous rupture of membranes (SROM) with the use of prostaglandin (PG) E2 in healthy parous women at term (gestational age at least 37 weeks).

METHODS:

An open randomized study was conducted with 100 parous women; 50 were treated conservatively for 24 hours, and 50 were managed actively using PGE2 gel (1 mg), administered at admission and repeated 6 hours later if labor was not established. Both groups received intravenous oxytocin if labor did not start within 24 hours after admission.

RESULTS:

The use of PGE2 gel led to a significant reduction in the mean interval (+/- standard error of the mean) from SROM to onset of labor: 17.26 +/- 1.51 hours in the conservative group versus 6.50 +/- 1.23 in the PGE2 group. A significantly smaller proportion of subjects required oxytocin in the PGE2 group (12 versus 38%, P < .02). The two groups were comparable with respect to analgesic requirements. Within 24 hours of SROM, 80% of the women in the PG group and 56% in the conservative group had delivered (P < .02). Most women delivered vaginally, 96% of those managed conservatively and 100% of those managed actively with PGE2.

CONCLUSION:

Active management using PGE2 gel in parous women with pre-labor SROM significantly improves the time to delivery without influencing the cesarean rate or fetal-maternal infective morbidity.

• Authors: T A Mahmood, M J Dick
• Journal: Obstetrics and gynecology (Obstet Gynecol) Vol. 85 Issue 1 Pg. 71-4 (Jan 1995) ISSN: 0029-7844 [Print] United States
• PMID: 7800329 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Anti-Bacterial Agents
• Gels
• Oxytocin
• Dinoprostone

Topics

• Administration, Intravaginal
• Adult
• Anti-Bacterial Agents (therapeutic use)
• Apgar Score
• Delivery, Obstetric (methods)
• Dinoprostone (therapeutic use)
• Female
• Fetal Membranes, Premature Rupture (drug therapy)
• Gels
• Humans
• Labor Onset (drug effects)
• Oxytocin (therapeutic use)
• Parity
• Pregnancy
• Puerperal Disorders (drug therapy, etiology)
• Time Factors