Premature Rupture of Membranes With a Bishop Score<6: Comparison of Medical Induction/Expectant Management
Condition: Medical Induction of Labor Affecting Newborn
MeSH terms: Fetal Membranes, Premature Rupture; Rupture
Study type: Interventional

Summary: 
      The study is intended to compare expectant management and on presentation labor induction in
      women with premature rupture of membranes.

      The means of labor induction and cervical ripening are either oxytocin or dinoprostone.

      Expectant management in this obstetrical state means waiting 24 hours from the onset of
      rupture of membranes and then commencing labor induction with either oxytocin or dinoprostone
      depending on the patient's obstetrical history and cervical condition.

      The investigators' hypothesis is that active management will lead to a higher rate of vaginal
      deliveries, a shorter interval between the time of rupture of membranes and the time of
      delivery, a lower rate of cesarean sections and a better obstetric result for the mother and
      the fetus/newborn.
    

Detailed description: 
      In the setting of premature rupture of membranes in term pregnancies, it is customary in
      women who are not in active labor to wait for 24 hours before attempting to induce labor. The
      means of labor induction used at our medical center are either intravenous oxytocin or
      per-vaginal dinoprostone, depending on patient's obstetric history and cervical conditions.

      The investigators hypothesize that commencing induction of labor at presentation in these
      women by either means of induction will lead to higher rates of vaginal delivery, shorter
      intervals between the time of onset of rupture of membranes and the time of delivery and
      lower rates of cesarean sections.

      The participants in the study, upon signing informed consents, will be randomized to 4
      groups-2 groups of expectant management in which labor induction will be commenced after 24
      hours with either oxytocin or dinoprostone and 2 groups of active management in which labor
      induction will be commenced at presentation with either oxytocin or dinoprostone.

      The participants will be followed from the time of presentation with rupture of membranes at
      the delivery room and until the time of delivery.

      Further obstetric, clinical and demographic information will be acquired from the patient's
      electronic medical file for analysis accuracy and sub-analysis.
    

Intervention name(s): Oxytocin; Dinoprostone
Intervention type(s): Drug; Drug
Intervention description(s): Labor induction and cervical ripening by oxytocin in women with premature rupture of membranes in 2 types of women:
Induction of labor on presentation at the delivery room.
Induction of labor after 24 hours of rupture of membranes.; Labor induction and cervical ripening by dinoprostone in women with premature rupture of membranes in 2 types of women:
Induction of labor on presentation at the delivery room.
Induction of labor after 24 hours of rupture of membranes.
Other intervention name(s): Pitocin; Cervidil
Intervention MeSH terms: Oxytocin; Dinoprostone
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment