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Prelabor Rupture of Membranes at Term: Induction Techniques

MOZURKEWICH, ELLEN MD, MS

Clinical Obstetrics & Gynecology:
Symposium on Cervical Ripening and Labor Induction
Abstract

The clinical management of premature rupture of membranes (PROM) at term has been a matter of considerable controversy. Management options have included expectant management or induction of labor with oxytocin, dinoprostone (PGE2), or misoprostol. Early studies suggested that immediate oxytocin induction of labor might reduce maternal and neonatal infections while increasing risk for cesarean section. The definitive TermPROM study found no difference in neonatal infections between immediate and delayed induction with oxytocin and PGE2. However, neither PGE2 nor delayed induction resulted in fewer cesarean sections than immediate oxytocin. Misoprostol offers several theoretical advantages over oxytocin in the setting of PROM at term. However, randomized trials to date have found no significant advantage for misoprostol administration compared with other agents for women with PROM.

Author Information

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Michigan School of Medicine, Ann Arbor, Michigan

Correspondence: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Michigan School of Medicine, Ann Arbor, MI. E-mail: mozurk@med.umich.edu

© 2006 Lippincott Williams & Wilkins, Inc.