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Archives of Disease in Childhood - Education and Practice 2007;92:ep125
Copyright © 2007 BMJ Publishing Group Ltd & Royal College of Paediatrics and Child Health.

EVIDENCE-BASED MEDICINE

Review: planned early birth after prelabour rupture of membranes at term has benefits for mother and infant

Dare MR, Middleton P, Crowther CA, et al. Planned early birth versus expectant management (waiting) for prelabour rupture of membranes at term (37 weeks or more). Cochrane Database Syst Rev 2006;(1):CD005302.

Q In pregnant women with prelabour rupture of membranes (PROM) at term, is planned early birth better for the mother and infant than expectant management?


Clinical impact ratings Obstetrics ******* Paediatrics *****{star}{star} Infectious disease ****{star}{star}{star}

Keywords: fetal membranes (premature rupture); labour (induced); term birth

The first 150 words of the full text of this article appear below.

METHODS


Formula

Data sources: Medline, EMBASE/Excerpta Medica, Cochrane Pregnancy and Childbirth Group Trials Register (November 2004), Cochrane Central Register of Controlled Trials (issue 4, 2004), and reference lists.


Formula

Study selection and assessment: randomised and quasi-randomised controlled trials (RCTs) that compared planned early birth (intervention implemented within 24 h) and expectant management (no intervention for >=24 h) in pregnant women with PROM at >=37 weeks’ gestation. 12 RCTs (n = 6846 women) reporting 13 comparisons met the selection criteria. The active management intervention used was induction of labour with oxytocin in 7 RCTs, prostaglandin in 5 RCTs, and caulophyllum in 1 RCT. 2 reviewers independently assessed methodological quality based on allocation concealment, blinding, and completeness of follow up.


Formula

Outcomes: caesarean delivery, operative vaginal delivery, maternal infection (chorioamnionitis and endometritis), perinatal death, neonatal infection, and admission to neonatal intensive care unit (NICU).

MAIN RESULTS

The time from PROM to birth was shortened by a mean 9.5 . . . [Full text of this article]

Haim A Abenhaim, MD, MPH and William D Fraser, MD, MSc

University of Montreal Montreal, Quebec, Canada


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