Use of amniotic fluid analysis in the management of preterm rupture of the membranes.

The management of preterm rupture of the membranes (PROM) must weigh the risks of respiratory distress from immediate delivery against those of expectant management. We divided 115 patients with PROM between 24 and 36 weeks of gestation into interventionist and expectant management groups on the basis of the amniotic fluid maturity. There was no difference between these groups with respect to gestational age and birth weight. Mature amniotic fluid was demonstrated in 41% of the patients. Interventionist management of infants with mature amniotic fluid irrespective of gestational age was associated with an improved outcome when compared to expectant management. Infants with PROM who can be shown to have mature amniotic fluid should be delivered promptly to avoid the small but real risks of expectant management.