Management of term pregnancy with premature rupture of the membranes and unfavourable cervix

Abstract

Sixty pregnant patients at term, who had premature rupture of the membranes and an unfavourable cervix were randomised to compare expectant management with oxytocin induction and with the use of prostaglandin E2 vaginal tablets for cervical ripening/induction of labour. Patients treated expectantly were placed on bed rest and observed for labour and infection. Patients managed by intervention were given intravenous oxytocin or 2 prostaglandin E2 tablets (0.5 mg) intravaginally every 6 hours. Between the three groups the duration of labour was longer in the oxytocin group and all 6 caesarean sections were performed on patients in this group. There was only 1 case of proven neonatal sepsis; this occurred in the oxytocin group. Patients with prostaglandin cervical ripening had a shorter hospital stay compared with patients treated expectantly. It is concluded that prostaglandin-induced cervical ripening is the method of choice in handling term patients with premature rupture of the membranes and an unfavourable cervix.