Document Detail

Induction of labor compared with expectant management for prelabor rupture of the membranes at term. TERMPROM Study Group.
MedLine Citation:
PMID:  8598837     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: As the interval between rupture of the fetal membranes at term and delivery increases, so may the risk of fetal and maternal infection. It is not known whether inducing labor will reduce this risk or whether one method of induction is better then another. METHODS: We studied 5041 women with prelabor rupture of the membranes at term. The women were randomly assigned to induction of labor with intravenous oxytocin; induction of labor with vaginal prostaglandin E2 gel; or expectant management for up to four days, with labor induced with either intravenous oxytocin or vaginal prostaglandin E2 gel if complications developed. The primary outcome was neonatal infection. Secondary outcomes were the need for cesarean section and women's evaluations of their treatment. RESULTS: The rates of neonatal infection and cesarean section were not significantly different among the study groups. The rates of neonatal infection were 2.0 percent for the induction-with-oxytocin group, 3.0 percent for the induction-with-prostaglandin group, 2.8 percent for the expectant-management (oxytocin) group, and 2.7 percent for the expectant-management (prostaglandin) group. The rates of cesarean section ranged from 9.6 to 10.9 percent. Clinical chorioamnionitis was less likely to develop in the women in the induction-with-oxytocin group than in those in the expectant-management (oxytocin) group (4.0 percent vs. 8.6 percent, P<0.001), as was postpartum fever (1.9 percent vs. 3.6 percent, P=0.008). Women in the induction groups were less likely to say they liked "nothing" about their treatment than those in the expectant-management groups. CONCLUSIONS: In women with prelabor rupture of the membranes at term, induction of labor with oxytocin or prostaglandin E2 and expectant management result in similar rates of neonatal infection and cesarean section. Induction of labor with intravenous oxytocin results in a lower risk of maternal infection than does expectant management. Women view induction of labor more positively than expectant management.
M E Hannah; A Ohlsson; D Farine; S A Hewson; E D Hodnett; T L Myhr; E E Wang; J A Weston; A R Willan
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The New England journal of medicine     Volume:  334     ISSN:  0028-4793     ISO Abbreviation:  N. Engl. J. Med.     Publication Date:  1996 Apr 
Date Detail:
Created Date:  1996-04-25     Completed Date:  1996-04-25     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  0255562     Medline TA:  N Engl J Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1005-10     Citation Subset:  AIM; IM    
Department of Obstetrics and Gynaecology, University of Toronto, Canada.
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MeSH Terms
Anti-Bacterial Agents / therapeutic use
Cesarean Section / statistics & numerical data
Chorioamnionitis / epidemiology
Dinoprostone / therapeutic use*
Fetal Death
Fetal Membranes, Premature Rupture / therapy*
Infant, Newborn
Infection / epidemiology
Labor, Induced* / methods
Oxytocin / therapeutic use*
Pregnancy Outcome
Reg. No./Substance:
0/Anti-Bacterial Agents; 363-24-6/Dinoprostone; 50-56-6/Oxytocin
Comment In:
N Engl J Med. 1996 Apr 18;334(16):1053-4   [PMID:  8598845 ]
N Engl J Med. 1996 Oct 10;335(15):1156-7; author reply 1158   [PMID:  8848021 ]
N Engl J Med. 1996 Oct 10;335(15):1157; author reply 1158   [PMID:  8848022 ]
N Engl J Med. 1996 Oct 10;335(15):1157-8   [PMID:  8848023 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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