Management of spontaneous rupture of the membranes in the absence of labor in primigravid women at term

Conway, D. I. , Prendiville, W. J., Morris, A., Speller, D. C.E. and Stirrat, G. M. (1984) Management of spontaneous rupture of the membranes in the absence of labor in primigravid women at term. American Journal of Obstetrics and Gynecology, 150(8), pp. 947-951. (doi: 10.1016/0002-9378(84)90388-0) (PMID:6507532)

Abstract

One hundred and thirty-five healthy primigravid women at or near term with spontaneous rupture of the membranes without uterine contractions were submitted to a prospective trial of management. Rupture of the membranes was diagnosed by speculum examination. If labor did not commence, induction was performed by oxytocin infusion starting at 9 am following admission. One hundred and five women went into labor spontaneously before induction became necessary. Sixty-three of these women required augmentation with oxytocin. Twenty-seven percent of the induced group required cesarean section delivery compared to 10% of those in spontaneous labor augmented by oxytocin and to none of those who did not require oxytocin (p < 0.01). Ninety-four percent of those in spontaneous labor were delivered vaginally compared to 73% of the induced group (p < 0.01). Forty-one percent of the augmented group were delivered by forceps. Awaiting the spontaneous onset of labor for 24 hours or less did not result in clinical maternal or neonatal infection. We would therefore advocate awaiting the spontaneous onset of labor after spontaneous rupture of membranes without contractions at or near term in healthy primigravid women for up to 24 hours because it seems to confer significant advantages without producing any additional hazard.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Conway, Professor David
• Authors: Conway, D. I., Prendiville, W. J., Morris, A., Speller, D. C.E., and Stirrat, G. M.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Dental School
• Journal Name: American Journal of Obstetrics and Gynecology
• Publisher: Elsevier
• ISSN: 0002-9378
• ISSN (Online): 1097-6868
• Published Online: 18 October 2013