Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2017 Mar 3;3(3):CD004735.
doi: 10.1002/14651858.CD004735.pub4.

Planned early birth versus expectant management for women with preterm prelabour rupture of membranes prior to 37 weeks' gestation for improving pregnancy outcome

Diana M Bond  1 , Philippa Middleton  2 , Kate M Levett  3   4 , David P van der Ham  5 , Caroline A Crowther  6   7 , Sarah L Buchanan  8 , Jonathan Morris  9   10
Affiliations
Review

Planned early birth versus expectant management for women with preterm prelabour rupture of membranes prior to 37 weeks' gestation for improving pregnancy outcome

Diana M Bond et al. Cochrane Database Syst Rev. .

Abstract

Background: Current management of preterm prelabour rupture of the membranes (PPROM) involves either initiating birth soon after PPROM or, alternatively, adopting a 'wait and see' approach (expectant management). It is unclear which strategy is most beneficial for mothers and their babies. This is an update of a Cochrane review published in 2010 (Buchanan 2010).

Objectives: To assess the effect of planned early birth versus expectant management for women with preterm prelabour rupture of the membranes between 24 and 37 weeks' gestation for fetal, infant and maternal well being.

Search methods: We searched Cochrane Pregnancy and Childbirth's Trials Register (30 September 2016), and reference lists of retrieved studies.

Selection criteria: Randomised controlled trials comparing planned early birth with expectant management for women with PPROM prior to 37 weeks' gestation. We excluded quasi-randomised trials.

Data collection and analysis: Two review authors independently evaluated trials for inclusion into the review and for methodological quality. Two review authors independently extracted data. We checked data for accuracy. We assessed the quality of evidence using the GRADE approach.

Main results: We included 12 trials in the review (3617 women and 3628 babies). For primary outcomes, we identified no clear differences between early birth and expectant management in neonatal sepsis (risk ratio (RR) 0.93, 95% confidence interval (CI) 0.66 to 1.30, 12 trials, 3628 babies, evidence graded moderate), or proven neonatal infection with positive blood culture (RR 1.24, 95% CI 0.70 to 2.21, seven trials, 2925 babies). However, early birth increased the incidence of respiratory distress syndrome (RDS) (RR 1.26, 95% CI 1.05 to 1.53, 12 trials, 3622 babies, evidence graded high). Early birth was also associated with an increased rate of caesarean section (RR 1.26, 95% CI 1.11 to 1.44, 12 trials, 3620 women, evidence graded high).Assessment of secondary perinatal outcomes showed no clear differences in overall perinatal mortality (RR 1.76, 95% CI 0.89 to 3.50, 11 trials, 3319 babies), or intrauterine deaths (RR 0.45, 95% CI 0.13 to 1.57, 11 trials, 3321 babies) when comparing early birth with expectant management. However, early birth was associated with a higher rate of neonatal death (RR 2.55, 95% CI 1.17 to 5.56, 11 trials, 3316 babies) and need for ventilation (RR 1.27, 95% CI 1.02 to 1.58, seven trials, 2895 babies, evidence graded high). Babies of women randomised to early birth were delivered at a gestational age lower than those randomised to expectant management (mean difference (MD) -0.48 weeks, 95% CI -0.57 to -0.39, eight trials, 3139 babies). Admission to neonatal intensive care was more likely for those babies randomised to early birth (RR 1.16, 95% CI 1.08 to 1.24, four trials, 2691 babies, evidence graded moderate).In assessing secondary maternal outcomes, we found that early birth was associated with a decreased rate of chorioamnionitis (RR 0.50, 95% CI 0.26 to 0.95, eight trials, 1358 women, evidence graded moderate), and an increased rate of endometritis (RR 1.61, 95% CI 1.00 to 2.59, seven trials, 2980 women). As expected due to the intervention, women randomised to early birth had a higher chance of having an induction of labour (RR 2.18, 95% CI 2.01 to 2.36, four trials, 2691 women). Women randomised to early birth had a decreased total length of hospitalisation (MD -1.75 days, 95% CI -2.45 to -1.05, six trials, 2848 women, evidence graded moderate).Subgroup analyses indicated improved maternal and infant outcomes in expectant management in pregnancies greater than 34 weeks' gestation, specifically relating to RDS and maternal infections. The use of prophylactic antibiotics were shown to be effective in reducing maternal infections in women randomised to expectant management.Overall, we assessed all 12 studies as being at low or unclear risk of bias. Some studies lacked an adequate description of methods and the risk of bias could only be assessed as unclear. In five of the studies there were one and/or two domains where the risk of bias was judged as high. GRADE profiling showed the quality of evidence across all critical outcomes to be moderate to high.

Authors' conclusions: With the addition of five randomised controlled trials (2927 women) to this updated review, we found no clinically important difference in the incidence of neonatal sepsis between women who birth immediately and those managed expectantly in PPROM prior to 37 weeks' gestation. Early planned birth was associated with an increase in the incidence of neonatal RDS, need for ventilation, neonatal mortality, endometritis, admission to neonatal intensive care, and the likelihood of birth by caesarean section, but a decreased incidence of chorioamnionitis. Women randomised to early birth also had an increased risk of labour induction, but a decreased length of hospital stay. Babies of women randomised to early birth were more likely to be born at a lower gestational age.In women with PPROM before 37 weeks' gestation with no contraindications to continuing the pregnancy, a policy of expectant management with careful monitoring was associated with better outcomes for the mother and baby.The direction of future research should be aimed at determining which groups of women with PPROM would not benefit from expectant management. This could be determined by analysing subgroups according to gestational age at presentation, corticosteroid usage, and abnormal vaginal microbiological colonisation. Research should also evaluate long-term neurodevelopmental outcomes of infants.

PubMed Disclaimer

Conflict of interest statement

Diana M Bond: I was employed as the Multi‐Center Trial Co‐ordinator for the NHMRC funded PPROMT trial which is included in this review. The NHMRC has had no input or influence regarding the publication of this review.

Philippa Middleton: none known.

Kate M Levett: acted as a trial co‐ordinator for the NHMRC (National Health and Medical Research Council) funded PPROMT trial, one of the included trials.

David P van der Ham: was Chief Investigator and first author of the PPROMEXIL trials. Jonathan Morris and Diana Bond were responsible for data extraction and assessment of all these trial reports.

Caroline A Crowther: was involved in the planning of the PPROMPT trial.

Sarah L Buchanan: was involved in the planning of the PPROMPT trial.

Jonathan Morris: was the Chief Investigator and first author for the NHMRC‐ (National Health and Medical Research Council) funded PPROMT trial.

Figures

1
1
Study flow diagram
2
2
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies
3
3
Risk of bias summary: review authors' judgements about each risk of bias item for each included study
4
4
Funnel plot of comparison: 1 Any planned birth versus expectant management: by type, outcome: 1.1 Neonatal infection/sepsis
5
5
Funnel plot of comparison: 1 Any planned birth versus expectant management: by type, outcome: 1.3 Respiratory distress syndrome
6
6
Funnel plot of comparison: 1 Any planned birth versus expectant management: by type, outcome: 1.4 Caesarean section
7
7
Funnel plot of comparison: 1 Any planned birth versus expectant management: by type, outcome: 1.5 Perinatal mortality
8
8
Funnel plot of comparison: 1 Any planned birth versus expectant management: by type, outcome: 1.6 Intrauterine death
9
9
Funnel plot of comparison: 1 Any planned birth versus expectant management: by type, outcome: 1.9 Neonatal death
10
10
Funnel plot of comparison: 1 Any planned birth versus expectant management: by type, outcome: 1.15 Birthweight (g)
11
11
Funnel plot of comparison: 1 Any planned birth versus expectant management: by type, outcome: 1.31 Vaginal birth
1.1
1.1. Analysis
Comparison 1 Any planned birth versus expectant management: by type, Outcome 1 Neonatal infection/sepsis.
1.2
1.2. Analysis
Comparison 1 Any planned birth versus expectant management: by type, Outcome 2 Neonatal infection confirmed with positive blood culture.
1.3
1.3. Analysis
Comparison 1 Any planned birth versus expectant management: by type, Outcome 3 Respiratory distress syndrome.
1.4
1.4. Analysis
Comparison 1 Any planned birth versus expectant management: by type, Outcome 4 Caesarean section.
1.5
1.5. Analysis
Comparison 1 Any planned birth versus expectant management: by type, Outcome 5 Perinatal mortality.
1.6
1.6. Analysis
Comparison 1 Any planned birth versus expectant management: by type, Outcome 6 Intrauterine death.
1.7
1.7. Analysis
Comparison 1 Any planned birth versus expectant management: by type, Outcome 7 Cord prolapse.
1.8
1.8. Analysis
Comparison 1 Any planned birth versus expectant management: by type, Outcome 8 Gestational age at birth (weeks).
1.9
1.9. Analysis
Comparison 1 Any planned birth versus expectant management: by type, Outcome 9 Neonatal death.
1.10
1.10. Analysis
Comparison 1 Any planned birth versus expectant management: by type, Outcome 10 Suspected neonatal infection.
1.11
1.11. Analysis
Comparison 1 Any planned birth versus expectant management: by type, Outcome 11 Neonatal treatment with antibiotics.
1.12
1.12. Analysis
Comparison 1 Any planned birth versus expectant management: by type, Outcome 12 Need for ventilation.
1.13
1.13. Analysis
Comparison 1 Any planned birth versus expectant management: by type, Outcome 13 Duration of oxygen therapy (days).
1.14
1.14. Analysis
Comparison 1 Any planned birth versus expectant management: by type, Outcome 14 Umbilical cord arterial pH.
1.15
1.15. Analysis
Comparison 1 Any planned birth versus expectant management: by type, Outcome 15 Birthweight (g).
1.16
1.16. Analysis
Comparison 1 Any planned birth versus expectant management: by type, Outcome 16 Apgar score less than 7 at 5 minutes.
1.17
1.17. Analysis
Comparison 1 Any planned birth versus expectant management: by type, Outcome 17 Abnormality on cerebral ultrasound.
1.18
1.18. Analysis
Comparison 1 Any planned birth versus expectant management: by type, Outcome 18 Periventricular leukomalacia.
1.19
1.19. Analysis
Comparison 1 Any planned birth versus expectant management: by type, Outcome 19 Cerebroventricular haemorrhage.
1.20
1.20. Analysis
Comparison 1 Any planned birth versus expectant management: by type, Outcome 20 Necrotising enterocolitis.
1.21
1.21. Analysis
Comparison 1 Any planned birth versus expectant management: by type, Outcome 21 Severe respiratory distress.
1.22
1.22. Analysis
Comparison 1 Any planned birth versus expectant management: by type, Outcome 22 Admission to neonatal intensive care unit.
1.23
1.23. Analysis
Comparison 1 Any planned birth versus expectant management: by type, Outcome 23 Length of stay in neonatal intensive care unit (days).
1.24
1.24. Analysis
Comparison 1 Any planned birth versus expectant management: by type, Outcome 24 Duration (days) from birth to neonatal hospital discharge.
1.25
1.25. Analysis
Comparison 1 Any planned birth versus expectant management: by type, Outcome 25 Chorioamnionitis.
1.26
1.26. Analysis
Comparison 1 Any planned birth versus expectant management: by type, Outcome 26 Endometritis.
1.27
1.27. Analysis
Comparison 1 Any planned birth versus expectant management: by type, Outcome 27 Postpartum fever.
1.28
1.28. Analysis
Comparison 1 Any planned birth versus expectant management: by type, Outcome 28 Placental abruption.
1.29
1.29. Analysis
Comparison 1 Any planned birth versus expectant management: by type, Outcome 29 Induction of labour.
1.30
1.30. Analysis
Comparison 1 Any planned birth versus expectant management: by type, Outcome 30 Use of epidural/spinal anaesthesia.
1.31
1.31. Analysis
Comparison 1 Any planned birth versus expectant management: by type, Outcome 31 Vaginal birth.
1.32
1.32. Analysis
Comparison 1 Any planned birth versus expectant management: by type, Outcome 32 Operative vaginal birth.
1.33
1.33. Analysis
Comparison 1 Any planned birth versus expectant management: by type, Outcome 33 Caesarean section for fetal distress.
1.34
1.34. Analysis
Comparison 1 Any planned birth versus expectant management: by type, Outcome 34 Duration (days) of maternal hospitalisation.
1.35
1.35. Analysis
Comparison 1 Any planned birth versus expectant management: by type, Outcome 35 Duration (days) of antenatal hospitalisation.
1.36
1.36. Analysis
Comparison 1 Any planned birth versus expectant management: by type, Outcome 36 Duration (days) of maternal hospitalisation (excluding trials with antenatal discharge).
1.37
1.37. Analysis
Comparison 1 Any planned birth versus expectant management: by type, Outcome 37 Time (hours) from randomisation to birth.
1.38
1.38. Analysis
Comparison 1 Any planned birth versus expectant management: by type, Outcome 38 Disability at 2 years, abnormal CBCL.
1.39
1.39. Analysis
Comparison 1 Any planned birth versus expectant management: by type, Outcome 39 Disability at 2 years, abnormal ASQ.
1.40
1.40. Analysis
Comparison 1 Any planned birth versus expectant management: by type, Outcome 40 Maternal satisfaction.
1.41
1.41. Analysis
Comparison 1 Any planned birth versus expectant management: by type, Outcome 41 Breastfeeding > 12 weeks.
2.1
2.1. Analysis
Comparison 2 Any planned birth versus expectant management (subgroup analysis by corticosteroid usage), Outcome 1 Neonatal infection.
2.2
2.2. Analysis
Comparison 2 Any planned birth versus expectant management (subgroup analysis by corticosteroid usage), Outcome 2 Neonatal infection confirmed with positive culture.
2.3
2.3. Analysis
Comparison 2 Any planned birth versus expectant management (subgroup analysis by corticosteroid usage), Outcome 3 Respiratory distress syndrome.
2.4
2.4. Analysis
Comparison 2 Any planned birth versus expectant management (subgroup analysis by corticosteroid usage), Outcome 4 Caesarean section.
2.5
2.5. Analysis
Comparison 2 Any planned birth versus expectant management (subgroup analysis by corticosteroid usage), Outcome 5 Chorioamnionitis.
2.6
2.6. Analysis
Comparison 2 Any planned birth versus expectant management (subgroup analysis by corticosteroid usage), Outcome 6 Endometritis.
3.1
3.1. Analysis
Comparison 3 Any planned birth versus expectant management (subgroup analysis by gestational age for inclusion in trial), Outcome 1 Neonatal infection.
3.2
3.2. Analysis
Comparison 3 Any planned birth versus expectant management (subgroup analysis by gestational age for inclusion in trial), Outcome 2 Neonatal infection confirmed with positive culture.
3.3
3.3. Analysis
Comparison 3 Any planned birth versus expectant management (subgroup analysis by gestational age for inclusion in trial), Outcome 3 Respiratory distress syndrome.
3.4
3.4. Analysis
Comparison 3 Any planned birth versus expectant management (subgroup analysis by gestational age for inclusion in trial), Outcome 4 Caesarean section.
3.5
3.5. Analysis
Comparison 3 Any planned birth versus expectant management (subgroup analysis by gestational age for inclusion in trial), Outcome 5 Chorioamnionitis.
3.6
3.6. Analysis
Comparison 3 Any planned birth versus expectant management (subgroup analysis by gestational age for inclusion in trial), Outcome 6 Endometritis.
4.1
4.1. Analysis
Comparison 4 Any planned birth versus expectant management (subgroup analysis by antibiotic use), Outcome 1 Neonatal infection.
4.2
4.2. Analysis
Comparison 4 Any planned birth versus expectant management (subgroup analysis by antibiotic use), Outcome 2 Neonatal infection confirmed with positive culture.
4.3
4.3. Analysis
Comparison 4 Any planned birth versus expectant management (subgroup analysis by antibiotic use), Outcome 3 Respiratory distress syndrome.
4.4
4.4. Analysis
Comparison 4 Any planned birth versus expectant management (subgroup analysis by antibiotic use), Outcome 4 Caesarean section.
4.5
4.5. Analysis
Comparison 4 Any planned birth versus expectant management (subgroup analysis by antibiotic use), Outcome 5 Chorioamnionitis.
4.6
4.6. Analysis
Comparison 4 Any planned birth versus expectant management (subgroup analysis by antibiotic use), Outcome 6 Endometritis.
5.1
5.1. Analysis
Comparison 5 Any planned birth versus expectant management (subgroup analysis by timing of early delivery), Outcome 1 Neonatal infection.
5.2
5.2. Analysis
Comparison 5 Any planned birth versus expectant management (subgroup analysis by timing of early delivery), Outcome 2 Neonatal infection confirmed with positive culture.
5.3
5.3. Analysis
Comparison 5 Any planned birth versus expectant management (subgroup analysis by timing of early delivery), Outcome 3 Respiratory distress syndrome.
5.4
5.4. Analysis
Comparison 5 Any planned birth versus expectant management (subgroup analysis by timing of early delivery), Outcome 4 Caesarean section.
5.5
5.5. Analysis
Comparison 5 Any planned birth versus expectant management (subgroup analysis by timing of early delivery), Outcome 5 Chorioamnionitis.
5.6
5.6. Analysis
Comparison 5 Any planned birth versus expectant management (subgroup analysis by timing of early delivery), Outcome 6 Endometritis.
See this image and copyright information in PMC

Update of

Comment in

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

References to studies included in this review

Cox 1995 {published data only}
    1. Cox SM, Leveno KJ. Intentional delivery vs expectant management with preterm ruptured membranes at 30‐34 weeks' gestation. Obstetrics & Gynecology 1995;86:875‐9. - PubMed
    1. Cox SM, Leveno KJ, Sherman ML, Travis L, DePalma R. Ruptured membranes at 30 to 34 weeks: intentional delivery vs expectant management. American Journal of Obstetrics and Gynecology 1995;172:412. - PubMed
Eroiz‐Hernandez 1997 {published data only}
    1. Eroiz‐Hernandez J, Trejo‐Acuna MA, Alvarez‐Tarin MH. Conservative management of premature membrane rupture in pregnancy of 28‐34 weeks. Aleatory clinical trial [Manejo conservador de ruptura prematura de membranas en embarazos de 28 a 34 semanas. Essayo clinico aleatorio]. Ginecologia y Obstetricia de Mexico 1997;65:43‐7. - PubMed
Garite 1981 {published data only}
    1. Garite TJ, Freeman RK, Linzey EM, Braly PS, Dorchester WL. Prospective randomised study in corticosteroids in the management of premature rupture of the membranes and the premature gestation. American Journal of Obstetrics and Gynecology 1981;141(5):508‐15. - PubMed
Iams 1985 {published data only}
    1. Iams JD, Talbert ML, Barrows H, Sachs L. Management of preterm prematurely ruptured membranes: a prospective randomized comparison of observation vs use of steroids and timed delivery. American Journal of Obstetrics and Gynecology 1985;151:32‐8. - PubMed
Koroveshi 2013 {published data only}
    1. Koroveshi G, Qirko R, Koroveshi E, Kuli G, Kodra N, Nurce A, et al. Incidence of sepsis in late preterm babies born from pregnancies complicated with premature preterm rupture of membranes. Journal of Perinatal Medicine 2013;41(Suppl 1):Abstract no:622.
Mercer 1993 {published data only}
    1. Mercer B, Crocker L, Boe N, Sibai B. Induction versus expectant management in PROM with mature amniotic fluid at 32‐36 weeks: a randomized trial. American Journal of Obstetrics and Gynecology 1993;168(1 Pt 2):295. - PubMed
    1. Mercer BM, Crocker LG, Boe NM, Sibai BM. Induction vs expectant management in premature rupture of the membranes with mature amniotic fluid at 32 to 36 weeks: a randomized trial. American Journal of Obstetrics and Gynecology 1993;169:775‐82. - PubMed
Morris 2016 {published data only}
    1. Morris J, Roberts CL, Bond DM, Crowther C. Immediate delivery versus expectant care in women with preterm prelabour rupture of the membranes close to term (PPROMT) ‐ a progress report. Journal of Paediatrics and Child Health 2012;48(Suppl 1):96.
    1. Morris JA, Roberts CL, Patterson JA, Bond DM, Crowther CA, Bowen JR, et al. Immediate delivery versus expectant care in women with preterm prelabour rupture of the membranes close to term (PPROMPT): a multi‐centre randomised controlled trial. Archives of Disease in Childhood 2014;99(Suppl 2):A223.
    1. Morris JM, Algert C, Crowther C, Bond D, Bowen J, Roberts CL. Preterm pre‐labour rupture of the membranes close to term (PPROMT) trial. Journal of Paediatrics and Child Health 2014;50(Suppl 1):23‐4.
    1. Morris JM, Roberts CL, Bowen JR, Patterson JA, Bond DM, Algert CS, et al. Immediate delivery compared with expectant management after preterm pre‐labour rupture of the membranes close to term (PPROMT trial): a randomised controlled trial. Lancet 2016;387(10017):444‐52. - PubMed
    1. Morris JM, Roberts CL, Crowther CA, Buchanan SL, Henderson‐Smart DJ, Salkeld G. Protocol for the immediate delivery versus expectant care of women with preterm prelabour rupture of the membranes close to term (PPROMT) trial. BMC Pregnancy and Childbirth 2006;6:9. - PMC - PubMed
Naef 1998 {published data only}
    1. Naef RW, Allbert JR, Ross EL, Weber M, Martin RW, Morrison JC. Premature rupture of membranes at 34 to 37 weeks' gestation: aggressive versus conservative management. American Journal of Obstetrics and Gynecology 1998;178(1):126‐30. - PubMed
    1. Naef RW, Allbert JR, Ross EL, Weber M, Martin RW, Morrison JC. Premature rupture of the membranes at 34‐37 weeks' gestation: aggressive vs conservative management. American Journal of Obstetrics and Gynecology 1994;170:340. - PubMed
Nelson 1985 {published data only}
    1. Nelson LH, Meis PJ, Hatjis CG, Ernest JM, Dillard R, Schey HM. Premature rupture of membranes: a prospective, randomized evaluation of steroids, latent phase, and expectant management. Obstetrics & Gynecology 1985; Vol. 66:55‐8. - PubMed
Spinnato 1987 {published data only}
    1. Spinnato JA, Shaver DC, Bray EM, Lipshitz J. Preterm premature rupture of the membranes with fetal pulmonary maturity present: a prospective study. Obstetrics & Gynecology 1987; Vol. 69:196‐201. - PubMed
    1. Spinnato JA, Shaver DC, Bray EM, Lipshitz J. Preterm premature rupture of the membranes with fetal pulmonary maturity present: a prospective study. Proceedings of 6th Annual Meeting of the Society of Perinatal Obstetricians; 1986 Jan 30‐Feb 1; San Antonio, Texas, USA. 1986:82.
Van der Ham 2012a {published data only}
    1. Mol BW, Vijgen S, Opmeer B, Bijlenga D, Akerboom B, Wijngaarden W, et al. Economic analysis of induction of labor versus expectant management in women with preterm prelabor rupture of membranes between 34 and 37 weeks (PPROMEXIL trial ISRCTN29313500). American Journal of Obstetrics and Gynecology 2011;204(1 Suppl):S336.
    1. Ham DP, Nijhuis JG, Mol BW, Beek JJ, Opmeer BC, Bijlenga D, et al. Induction of labour versus expectant management in women with preterm prelabour rupture of membranes between 34 and 37 weeks (the PPROMEXIL‐trial). BMC Pregnancy and Childbirth 2007;7:11. - PMC - PubMed
    1. Ham DP, Vijgen SMC, Nijhuis JG, Beek JJ, Opmeer BC, Mulder ALM, et al. Induction of labor versus expectant management in women with preterm prelabor rupture of membranes between 34 and 37 weeks: a randomized controlled trial. PLoS Medicine 2012;9(4):e1001208. - PMC - PubMed
    1. Heyden J, Willekes C, Oudijk M, Porath M, Duvekot H, Bloemenkamp KWM, et al. Behavioural and developmental outcome of neonates at 2 years of age after preterm prelabor rupture of membranes: follow up of the PPROMEXIL trial. American Journal of Obstetrics and Gynecology 2014;210(1 Suppl):S349‐50.
    1. Heyden JL, Willekes C, Baar AL, Wassenaer‐Leemhuis AG, Pajkrt E, Oudijk MA, et al. Behavioural and neurodevelopmental outcome of 2‐year‐old children after preterm premature rupture of membranes: follow‐up of a randomised clinical trial comparing induction of labour and expectant management. European Journal of Obstetrics, Gynecology, and Reproductive Biology 2015;194:17‐23. - PubMed
Van der Ham 2012b {published data only}
    1. Tajik P, Ham DP, Zafarmand MH, Hof MHP, Morris J, Franssen MTM, et al. Using vaginal Group B Streptococcus colonisation in women with preterm premature rupture of membranes to guide the decision for immediate delivery: a secondary analysis of the PPROMEXIL trials. BJOG: an international journal of obstetrics and gynaecology 2014;121:1263‐73. - PubMed
    1. Ham D, Heijden J, Opmeer B, Beek H, Willekes C, Mulder T, et al. Induction of labor versus expectant management in women with preterm prelabor rupture of membranes between 34 and 37 weeks ‐ the PPROMEXIL‐2 trial (ISRCTN05689407). American Journal of Obstetrics and Gynecology 2012;206(Suppl 1):S8‐9.
    1. Ham DP, Heyden JL, Opmeer BC, Mulder AL, Moonen RM, Beek JH, et al. Management of late‐preterm premature rupture of membranes: the PPROMEXIL‐2 trial. American Journal of Obstetrics and Gynecology 2012;207(4):276.e1‐e10. - PubMed
    1. Vijgen SM, Ham DP, Bijlenga D, Beek JJ, Bloemenkamp KW, Kwee A, et al. Economic analysis comparing induction of labor and expectant management in women with preterm prelabor rupture of membranes between 34 and 37 weeks (PPROMEXIL trial). Acta Obstetricia et Gynecologica Scandinavica 2014; Vol. 93, issue 4:374‐81. - PubMed

References to studies excluded from this review

Bergstrom 1991 {published data only}
    1. Bergstrom S. A prospective study on the perinatal outcome in Mozambican pregnant women with preterm rupture of membranes using two different methods of clinical management. Gynecologic & Obstetric Investigation 1991;32:217‐9. - PubMed
Cararach 1994 {published data only}
    1. Cararach V, Sentis J, Botet F, Costa J, Manau D, Arimany MC. Cervical prostaglandin E2 compared with expectant management or systematic induction in PROM with bad cervical conditions: I‐maternal results. Proceedings of 14th European Congress of Perinatal Medicine; 1994 June 5‐8; Helsinki, Finland. 1994:405.
Decavalas 1995 {published data only}
    1. Decavalas G, Mastrogiannis D, Papadopoulos V, Tzingounis V. Short‐term vs long‐term prophylactic tocolysis in patients with preterm premature rupture of membranes. European Journal of Obstetrics & Gynecology and Reproductive Biology 1995;59:143‐7. - PubMed
    1. Decavalas G, Papadopoulos V, Tsapanos V, Tzingounis V. Tocolysis in patients with preterm premature rupture of membranes has any effect on pregnancy outcome?. International Journal of Gynecology & Obstetrics 1994;46:26.
El‐Qarmalawi 1990 {published data only}
    1. El‐Qarmalawi AM, Elmardi AA, Saddik M, El‐Abdel Hadi F, Shaker SMA. A comparative randomized study of oral prostaglandin E2 (PGE2) tablets and intravenous oxytocin in induction of labor in patients with premature rupture of membranes before 37 weeks of pregnancy. International Journal of Gynecology & Obstetrics 1990;33:115‐9. - PubMed
Fayez 1978 {published data only}
    1. Fayez JA, Hasan AA, Jonas HS, Miller GL. Management of premature rupture of the membranes. Obstetrics & Gynecology 1978; Vol. 52:17‐21. - PubMed
Gloeb 1989 {published data only}
    1. Gloeb DJ, O'Sullivan MJ, Beydoun SN. Relationship of the interval between spontaneous premature rupture of the membranes and inducibility of labor. Proceedings of 9th Annual Meeting of the Society of Perinatal Obstetricians; 1989 February 1‐4; New Orleans, Louisiana, USA. 1989:493.
Griffith‐Jones 1990 {published data only}
    1. Griffith‐Jones MD, Tyrrell SN, Tuffnell DJ. A prospective trial comparing intravenous oxytocin with vaginal prostaglandin E2 tablets for labour induction in cases of spontaneous rupture of the membranes. Obstetrics and Gynaecology Today 1990;1(4):104‐5.
Haghighi 2006 {published data only}
    1. Haghighi L. Intravaginal misoprostol in preterm premature rupture of membranes with low Bishop scores. International Journal of Gynecology & Obstetrics 2006;94(2):121‐2. - PubMed
Lacaze 2006 {published data only}
    1. Lacaze N. Safety and efficacy study of intentional delivery in women with preterm and prelabour rupture of the membranes (ongoing trial). www.clinicaltrials.gov (accessed 21 March 2006) 2006.
Ladfors 1996 {published data only (unpublished sought but not used)}
    1. Ladfors L, Mattsson LA, Eriksson M, Fall O. A randomised trial of two expectant managements of prelabour rupture of the membranes at 34 to 42 weeks. British Journal of Obstetrics and Gynaecology 1996;103:755‐62. - PubMed
    1. Ladfors L, Mattsson LA, Eriksson M, Fall O. A randomized prospective trial of two expectant managements of pre‐labor rupture of the membranes (PROM) at 34‐42 weeks. American Journal of Obstetrics and Gynecology 1994;170:344.
    1. Ladfors L, Tessin I, Fall O, Erikson M, Matsson LA. A comparison of neonatal infectious outcome comparing two expectant managements of women with prelabor rupture of the membranes at 34‐42 weeks. American Journal of Obstetrics and Gynecology 1998;178(1 Pt 2):S197.
Makhlouf 1997 {published data only}
    1. Makhlouf AM, Moemen A, Abdelaleem K, Abdelaleem H. Induction versus expectant management in preterm premature rupture of membranes. Research activities on reproductive health: annual report of Assiut University Department of Obstetrics and Gynecology November 1997. Assiut University, Faculty of Medicine, 1997:12.
Mateos 1998 {published data only}
    1. Mateos D, Cararach V, Sentis J, Botet F, Figueras F, Arimany M, et al. Cervical prostaglandin E2 compared with expectant management or systematic induction in premature rupture of the membranes with bad cervical conditions. Prenatal and Neonatal Medicine 1998;1(Suppl 1):85.
Miodovnik 1988 {published data only}
    1. Miodovnik M, Smith PP. Management of prelabour rupture of the membranes at 32‐36 weeks with prostaglandin present in the vaginal pool. Personal communication 1988.
Parsons 1989 {published data only}
    1. Parsons MT, Sobel D, Cummiskey K, Roitman J, Gall SA. Early delivery vs expectant management in patients with preterm rupture of membranes at 32‐36 weeks gestation. Proceedings of 9th Annual Meeting of the Society of Perinatal Obstetricians; 1989 Feb 1‐4; New Orleans, Louisiana, USA. 1989:391.
Perez 1992 {published data only}
    1. Perez Picanol E, Vernet M, Armengol R, Perez Ares C, Lecumberri J, Gamissans O. Comparison of two different therapeutic attitudes in premature rupture of membranes. Journal of Perinatal Medicine 1992;20:353.
Van Heerden 1996 {published data only}
    1. Heerden J, Steyn DW. Management of premature rupture of the membranes after 34 weeks' gestation ‐ early versus delayed induction of labour. South African Medical Journal 1996;86:262‐6. - PubMed

References to ongoing studies

Pasquier 2006 {published data only}
    1. Pasquier JC, Bujold E, Mellie G. Preterm premature rupture of membranes: is there an optimal gestational age for delivery?. Obstetrics & Gynecology 2005;105(6):1484‐5. - PubMed
    1. Pasquier JC, Claris O, Rabilloud M, Picaud JC, Moret S, Ecochard R, et al. Feeling and motivation of women to participate in a randomized control trial in perinatality. American Journal of Obstetrics and Gynecology 2006;195(6 Suppl 1):S69.

Additional references

Arias 1982
    1. Arias F, Tomich P. Etiology and outcome of low birthweight and preterm infants. Obstetrics & Gynecology 1982;338:663‐70. - PubMed
Deeks 2011
    1. Deeks JJ, Higgins JPT, Altman DG (editors). Chapter 9: Analysing data and undertaking meta‐analyses. In: Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from handbook.cochrane.org.
Engle 2007
    1. Engle WA, Tomashek KM, Wallman C. Late preterm infants: a population at risk. Pediatrics 2007;120:1390‐401. - PubMed
Engle 2008
    1. Engle WA, Kominiarek MA. Late preterm infants, early term infants, and timing of elective deliveries. Clinics in Perinatology 2008;35:325‐41. - PubMed
Gaudet 2001
    1. Gaudet L, Smith GN. Cerebral palsy and chorioamnionitis: the inflammatory cytokine link. Obstetrical and Gynecological Survey 2001;56(7):433‐6. - PubMed
Gonen 1989
    1. Gonen R, Hannah ME, Milligan JE. Does prolonged preterm premature rupture of the membranes predispose to abruptio placentae?. Obstetrics & Gynecology 1989;74(3):347‐50. - PubMed
Hannah 1996
    1. Hannah ME, Ohlsson A, Farine D, Hewson SA, Hodnett ED, Myhr TL, et al. Induction of labor compared with expectant management for prelabor rupture of the membranes at term. New England Journal of Medicine 1996;334(16):1005‐10. - PubMed
Harding 2001
    1. Harding JE, Pang JM, Knight DB, Liggins GC. Do antenatal corticosteroids help in the setting of preterm rupture of membranes?. American Journal of Obstetrics and Gynecology 2001;184:131‐9. - PubMed
Higgins 2003
    1. Higgins JPT, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta‐analyses. BMJ 2003;327:557‐60. - PMC - PubMed
Higgins 2011
    1. Higgins JPT, Altman DG, Sterne JAC (editors). Chapter 8: Assessing risk of bias in included studies. In: Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from handbook.cochrane.org.
Jones 2000
    1. Jones SC, Brost BC, Brehm WT. Should intravenous tocolysis be considered beyond 34 weeks' gestation?. American Journal of Obstetrics and Gynecology 2000;183(2):356‐60. - PubMed
Kenyon 2001
    1. Kenyon S, Taylor DJ, Tarnow‐Mordi W. Broad spectrum antibiotics for preterm, prelabour rupture of the fetal membranes: the ORACLE I randomised trial. Lancet 2001;357:979‐88. - PubMed
Kenyon 2003
    1. Kenyon S, Boulvain M, Neilson J. Antibiotics for preterm premature rupture of the membranes. Cochrane Database of Systematic Reviews 2003, Issue 2. [DOI: 10.1002/14651858.CD001058] - DOI - PubMed
Lee 2001
    1. Lee T, Silver H. Etiology and epidemiology of preterm premature rupture of the membranes. Clinical Perinatology 2001;28:721‐34. - PubMed
Lewis 1996
    1. Lewis DF, Futayyeh S, Towers CV, Asrat T, Edwards MS, Brooks GG. Preterm delivery from 34‐37 weeks gestation: is respiratory distress syndrome a problem?. American Journal of Obstetrics and Gynecology 1996;174(2):525‐8. - PubMed
Major 1995
    1. Major CA, Veciana M, Lewis DF, Morgan MA. Preterm premature rupture of the membranes and abruptio placentae: is there an association between these pregnancy complications?. American Journal of Obstetrics and Gynecology 1995;172(2):672‐6. - PubMed
Mercer 2000
    1. Mercer BM, Goldenberg RL, Meis PJ, Moawad AH, Shellhaas C, Das A, et al. The preterm prediction study: prediction of preterm premature rupture of the membranes through clinical findings and ancillary testing. American Journal of Obstetrics and Gynecology 2000;183:738‐45. - PubMed
Mercer 2003
    1. Mercer BM. Preterm premature rupture of the membranes. Obstetrics & Gynecology 2003;101(1):178‐93. - PubMed
Mercer 2005
    1. Mercer BM. Preterm premature rupture of the membranes: current approaches to evaluation and management. Obstetrics and Gynecology Clinics of North America 2005;32:411‐28. - PubMed
Middleton 2017
    1. Middleton P, Shepherd E, Flenady V, McBain RD, Crowther CA. Planned early birth versus expectant management (waiting) for prelabour rupture of membranes at term (37 weeks or more). Cochrane Database of Systematic Reviews 2017, Issue 1. [DOI: 10.1002/14651858.CD005302.pub3] - DOI - PMC - PubMed
Neerhof 1999
    1. Neerhof MG, Cravello C, Haney EI, Silver RK. Timing of labor induction after premature rupture of membranes between 32 and 36 weeks gestation. American Journal of Obstetrics and Gynecology 1999;180(2):349‐52. - PubMed
RevMan 2014 [Computer program]
    1. The Nordic Cochrane Centre, The Cochrane Collaboration. Review Manager (RevMan). Version 5.3. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2014.
Roberts 2006
    1. Roberts D, Dalziel S. Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth. Cochrane Database of Systematic Reviews 2006, Issue 3. [DOI: 10.1002/14651858.CD004454.pub2] - DOI - PubMed
Robertson 1992
    1. Robertson PA, Sniderman SH, Laros RK Jr, Cowan R, Heilbron D, Goldenberg RL, et al. Neonatal morbidity according to gestational age and birth weight from five tertiary care centers in the United States, 1983 through 1986. American Journal of Obstetrics and Gynecology 1992;166:1629‐45. - PubMed
Seo 1992
    1. Seo K, McGregor JA, French JI. Preterm birth is associated with increased risk of maternal and neonatal infection. Obstetrics & Gynecology 1992;79:75‐80. - PubMed
Sterne 2011
    1. Sterne JAC, Egger M, Moher D (editors). Chapter 10: Addressing reporting biases. In: Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Intervention. Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from handbook.cochrane.org.
Wu 2000
    1. Wu YW, Colford JM. Chorioamnionitis as a risk factor for cerebral palsy: a meta‐analysis. JAMA 2000;284(11):1417‐24. - PubMed

References to other published versions of this review

Buchanan 2010
    1. Buchanan SL, Crowther CA, Levett KM, Middleton P, Morris J. Planned early birth versus expectant management for women with preterm prelabour rupture of membranes prior to 37 weeks' gestation for improving pregnancy outcome. Cochrane Database of Systematic Reviews 2010, Issue 3. [DOI: 10.1002/14651858.CD004735.pub3] - DOI - PubMed

MeSH terms