Effects of digital cervical examinations on duration of latency period, maternal and neonatal outcome in preterm premature rupture of membranes.

The medical records of 115 singleton pregnancies by preterm PROM from Chulalongkorn Hospital that met the criteria for expectant treatment from January 1987 to December 1991 were reviewed. All cases were divided into 2 groups. Fifty cases had a digital cervical examination to assess cervical status and sixty-five cases had a sterile speculum examination only. Latency period, maternal and neonatal outcome of both groups were compared. There was no statistically significant difference between the latency period of both groups (34.19 +/- 78.35 versus 54.6 +/- 127.01 hours). This was consistent for all gestational age groups. There was statistically significant increased incidence of chorioamnionitis in patients receiving digital cervical examinations. A nonsignificant trend toward an increased incidence of endometritis was also noted in patients receiving digital cervical examinations. There was no statistically significant differences in the average time of delivery, mode of delivery and postpartum hospitalization between both groups. No maternal mortality and stillbirth was noted in this study. There were no statistically significant differences in Apgar score at 1 minute and 5 minute, NICU admittance, neonatal hospitalization and percentage of neonatal deaths, livebirths, and neonatal morbidity between both groups. The results of this study suggest that digital cervical examinations in patients with preterm PROM should be avoided until the clinician is convinced that the patient is clearly in labor because digital cervical examinations increase the incidence of chorioamnionitis and endometritis but have no effect on latency period.