Prelabour rupture of membranes to delivery interval related to the incidence of maternal and neonatal infection

Abstract

Objective: To assess the infectious morbidity associated with prelabour rupture of membranes (PROM) to delivery interval, and the incidence of maternal and neonatal infection in a population managed by either immediate stimulation or by overnight conservatism. Method: A retrospective study of 117 women admitted with PROM to the labour ward in the National University Hospital, Singapore, in the period between June 1990 and May 1991, and who were managed by immediate stimulation or by stimulation after overnight conservatism. Statistical analysis was performed using Chi-square and Student's t-test. Results: More than one third of infants whose mothers had ruptured membranes for > 48 hrs had signs of neonatal infection, compared with an incidence of 8.8% and 8.9%, respectively for those with an interval of < 12 hrs and 12-24 hrs between PROM to delivery. Group B streptococcal infection was a major cause of neonatal infectious morbidity. Clinical evidence of maternal infection occurred in 3 of the 117 women; these patients had an interval between rupture of membranes and delivery of between 24-76 hrs. Conclusions: Prolongation of PROM to delivery interval for > 48 hrs increases the incidence of infection. Conservative policy of management of PROM at term should aim to deliver the babies < 48 hrs after PROM. The difference in maternal and neonatal infection rates were not significant in the group treated with a policy of overnight conservatism compared with the group in whom labour was stimulated immediately on admission.