Management of Rupture of Membranes at Term in Low-Risk Obstetric Population

ABSTRACT. Objective: To compare the outcomes of expectant versus active management of patients presenting with premature rupture of membranes (PROM) at term. Design: Observational case-controJ study over a period of 30 months. Setting: King AbduJaziz University Hospital,Jeddah, Saudi Arabia. Subjects: All obstetric patients with no obstetric risk factors other than PROM at term were included in the present study. Each patient was matched with a control case who had started labor with intact membranes. Outcome Measures: Duration of Jabor, fetal distress, intrapartum pyrexia, rate of cesarean section delivery, and Apgar scores at birth. Results: The duration of Jaborwas shorter in patients with PROM compared to the control group, but the difference was not statistically significant. Fur-thermore, cesarean section rate was 4.5 % in the PROM group versus 7.6 % in the control group. Among patients with PROM who received active man-agement, the rates of intrapartum pyrexia and cesarean sections were almost twice that in patients who were managedexpectantly. Conclusion: In the absence of other maternal and/or obstetric risk factors, PROM does not seem to constitute additional obstetric risks. Furthermore, ex-pectant management of PROM in anticipation of spontaneous uterine contrac-tions increases the changes of normaldelivery without an increase in fetal and/ or maternal morbidity