When a pregnant woman's membranes break before 37 weeks' gestation in pregnancy without contractions, the management choice is to deliver the baby soon or to wait for spontaneous labour to occur or delivery at term. The health benefits for continuing a pregnancy can depend on how near the mother is to term and so the likelihood of risks of prematurity, including respiratory distress and prolonged stays in the neonatal nursery. Remaining in the womb has potential harms for both mother and baby including infections that can cause neonatal sepsis, fetal distress and death.
We included seven trials that involved 690 women with preterm rupture of the membranes without labour. The women were between 25 to 36 weeks of pregnancy. The studies were all performed in the United States of America between 1977 and 1994.
Neonatal sepsis and respiratory distress were not clearly different for babies born in the early delivery or expectant management groups. The overall number of perinatal deaths was also not clearly different between the treatment groups.The length of stay in either a neonatal intensive care unit or special care nursery was not clearly different between the treatment groups.
Early planned delivery may result in an increase in caesarean delivery for the mother but if this delivery is within 24 hours of rupture of the membranes a decrease in the rate of infection of the placenta and fetal membranes and a shorter hospital stay for the mother.