Ladfors L, Mattsson L A, Eriksson M, Fall O
Department of Obstetrics, East Hospital, University of Göteborg, Sweden.
Br J Obstet Gynaecol. 1996 Aug;103(8):755-62. doi: 10.1111/j.1471-0528.1996.tb09869.x.
To compare obstetric and perinatal outcome between two different expectant managements in women with prelabour rupture of the membranes (PROM).
A randomised study.
One thousand three hundred and eighty-five women with rupture of the membranes at 34 to 42 weeks without contractions.
Women without contractions 2 h after admission were randomised to early induction the following morning after PROM (early induction group) or induction two days later (late induction group). Women with contractions starting within 2 h after admission were included in the calculations as a short latency group. Digital examinations of the cervix were avoided until onset of active labour. Labour was induced with oxytocin in both groups if no spontaneous contractions occurred or if chorioamnionitis or fetal distress was detected.
The frequency of spontaneous deliveries, operative deliveries, maternal and neonatal infections.
In nulliparous women, a higher rate of spontaneous deliveries was found in the late induction group (89%) compared with the early induction group (81%) (P < 0.05). The ventouse extraction rate was 7% and 14% respectively (P < 0.05). A low (2-4%) caesarean section rate was recorded and did not differ between the groups. Endometritis was detected in six women after delivery. Sixty-one children were treated with antibiotics, and no difference could be detected between the groups.
A higher rate of spontaneous deliveries was found among nulliparous women with prolonged latency as compared with brief latency prior to induction. A protocol of no digital examination before labour was associated with infrequent maternal and fetal morbidity, regardless of latency.
比较胎膜早破（PROM）孕妇两种不同期待管理方式下的产科及围产期结局。
一项随机研究。
1385例孕34至42周胎膜破裂且无宫缩的孕妇。
入院后2小时无宫缩的孕妇被随机分为胎膜早破后次日清晨早期引产组（早期引产组）或两天后引产组（晚期引产组）。入院后2小时内开始宫缩的孕妇作为短潜伏期组纳入计算。在活跃分娩开始前避免进行宫颈指检。若未出现自发宫缩或检测到绒毛膜羊膜炎或胎儿窘迫，两组均用缩宫素引产。
自然分娩、手术分娩、母婴感染的发生率。
初产妇中，晚期引产组自然分娩率（89%）高于早期引产组（81%）（P<0.05）。胎头吸引术使用率分别为7%和14%（P<0.05）。剖宫产率较低（2 - 4%），两组间无差异。产后6名妇女被检测出患有子宫内膜炎。61名儿童接受了抗生素治疗，两组间未发现差异。
与引产前行潜伏期较短者相比，潜伏期延长的初产妇自然分娩率更高。无论潜伏期长短，分娩前不进行指检的方案与母婴发病率较低相关。
