Giving pregnant women antibiotics when their membranes rupture at or near term without the onset of labour may reduce the risk of infections for the women. More research is needed on the safety and impact of the antibiotics on their babies. Sometimes the membranes (creating a bag of liquid around the unborn baby) break when the baby is due without the onset of regular uterine contractions. This is called PROM (prelabour rupture of membranes). When this happens, there is a risk of infection entering the womb (uterus) and affecting the mother and her baby. Most of the women spontaneously start regular uterine contractions within 24 hours, although some do not. The women are often given antibiotics to prevent infection but there are concerns about possible adverse effects of antibiotic use. The other main management strategy is to induce labour with oxytocin.
The review of trials found that routine antibiotics for term PROM reduced the risk of infection of the uterus for the pregnant woman. There was not enough strong evidence about other outcomes, including infections and complications for the baby. Only two trials involving a total of 838 women with PROM were identified. The conclusions from this review are limited by the small numbers of women enrolled in the identified trials and the low rate of maternal infection in the control groups. There is insufficient information in this review to assess possible adverse effects from the use of antibiotics for women or their infants.