Premature rupture of membranes at term on unfavourable cervix: Immediate or delayed induction? [Rupture prématurée des membranes à terme sur col défavorable: quel délai pour déclencher ?]

摘要

Objectives To define the optimal delay before inducing labor in the management of premature rupture of the membranes (PRM) at term with unfavourable cervix in order to reduce the risk of caesarean section as well as the risk of maternal and foetal infection. Materials and methods Retrospective study of three homogeneous groups carried out over on a period of 4 years in two centres. All the patients were included after premature rupture of membranes at term with unfavourable cervix (Bishop score < 6). We defined three expected delays after PRM at term: less than 7 h (group 1), between 7 and 12 h (group 2) and more than 12 h (group 3). We have assessed the obstetrical, maternal and foetal consequences for each group. Results Sixty patients were allocated in group 1, 49 in group 2 and 46 in group 3. There was no significant difference in the rate of caesarean between the three groups but it was lower in group 2: 6.1% versus 18.3% in group 1 and 21.7% in group 3. No statistical difference was observed concerning maternal or foetal infections. Conclusion In PRM at term, neither our study nor literature data allow us to conclude about the optimal delay before inducing labor.