Document Detail

A comparison of early and delayed induction of labor with spontaneous rupture of membranes at term.
MedLine Citation:
PMID:  2733949     Owner:  NLM     Status:  MEDLINE    
The management of women with spontaneous rupture of membranes at term in the absence of labor and with a cervix unfavorable for induction of labor is controversial. In this randomized study of 182 patients, we report the effects of delayed versus early induction of labor on maternal and neonatal outcome. Qualifying patients not in labor at 6 hours after spontaneous rupture of membranes were randomized to either immediate oxytocin induction (86 women) or expectant management with oxytocin induction at 24 hours if labor had not occurred spontaneously (96 women). The cesarean section rate did not differ between the two groups. Women in the delayed group had significantly longer hospitalization (P less than .003), and their infants were significantly more likely to receive antibiotics (P = .006). Infectious morbidity (positive cultures or x-ray-documented pneumonia) occurred in five of the neonates in the delayed group, all of whose mothers had an initial digital cervical examination, but in none of the neonates in the early group, a difference that did not reach statistical significance (P = .061). Five (28%) of 18 infants from the delayed group whose mothers had received an initial digital cervical examination became infected, compared with none of the 78 infants from the delayed group whose mothers did not have digital examinations (P less than .001). We conclude that there is no advantage to delaying induction of labor when women present at term with spontaneous rupture of membranes.
M V Wagner; V P Chin; C J Peters; B Drexler; L A Newman
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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:  Obstetrics and gynecology     Volume:  74     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  1989 Jul 
Date Detail:
Created Date:  1989-07-21     Completed Date:  1989-07-21     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  93-7     Citation Subset:  AIM; IM    
Department of Obstetrics and Gynecology, Kaiser Permanente Medical Center, Oakland, California.
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MeSH Terms
Cesarean Section
Endometritis / epidemiology
Fetal Distress / epidemiology
Infant, Newborn
Labor, Induced / methods*
Length of Stay
Obstetrics / methods*
Pregnancy Outcome
Puerperal Infection / epidemiology
Random Allocation
Time Factors

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