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Management of pre-labour rupture of membranes at term - a survey of current practice in Australia.
MedLine Citation:
PMID:  21039375     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND: Women with pre-labour rupture of membranes at term (Term-PROM) commonly choose to have early induction of labour with the use of oxytocin. Although there is evidence of efficacy and safety of induction by the use of prostaglandin, it is used infrequently in Australia.
AIMS: To identify current practice and views of obstetricians in Australia, on Term-PROM.
METHODS: A postal survey among all obstetricians in Australia in April 2009. Fellows no longer practising obstetrics or who were non-practising were asked to return the survey without completing it.
RESULTS: Of the 1319 surveys posted, 720 (54.6%) were returned, 23.8% of whom were practising only gynaecology or non-practising, leaving 548 respondents practising obstetrics (41.5%). The most common management of Term-PROM is induction of labour (IOL) within 24 h at the next convenient opportunity (75%). More than 96% would use intravenous oxytocin at some stage as their method of induction. Prostaglandin gel (PGE₂) was utilised by 15% of respondents regularly, mainly for ripening of an unfavourable cervix in a primigravida, but nearly 40% would consider the use of PGE₂ indicating that it would produce a more 'natural' labour, that women could ambulate more and that there would be reduced impact on midwifery staff. For those who would not consider PGE₂, the most common reasons were concerns of hyperstimulation, increased infection rate and precautions of use based on product information. Conclusions:  Oxytocin is the most widely used induction agent for women with term-PROM. PGE₂ is an important alternative method of induction and nearly 40% would consider using it. Clarification from RANZCOG and further studies on whether PGE₂ offers a safe and effective option are now required.
Authors:
Christopher R Weekes; Kassam Mahomed
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Australian & New Zealand journal of obstetrics & gynaecology     Volume:  50     ISSN:  1479-828X     ISO Abbreviation:  Aust N Z J Obstet Gynaecol     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-11-02     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0001027     Medline TA:  Aust N Z J Obstet Gynaecol     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  428-31     Citation Subset:  IM    
Copyright Information:
© 2010 The Authors. Australian and New Zealand Journal of Obstetrics and Gynaecology © 2010 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.
Affiliation:
Obstetrics and Gynaecology department, Nambour General Hospital, Nambour, Queensland, Australia. weekesc@iinet.net.au
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