Comparison of vaginal prostaglandin E2 delivery system versus expectant management in term premature rupture of membranes

Background: Premature rupture of the membranes (PROM) occurring after the 37th week of gestation, prior to the onset of regular contractions, affects approximately 8% of pregnancies and typically leads to the spontaneous onset of labor. A prolonged interval between PROM and delivery increases the risk of maternal infection and early neonatal sepsis. This prospective, randomized study aimed to assess the efficacy, safety, and maternal satisfaction associated with the use of a vaginal prostaglandin E2 (PGE2) delivery system compared to expectant management approach following PROM. Methods: Term pregnant women with a singleton cephalic presentation, who experienced PROM within 4–12 hours and had an unripe cervix, were randomized into 2 groups. The intervention group received labor induction using a slow-release 10 mg dinoprostone (PGE2) vaginal delivery system, whereas the control group underwent expectant management. If active labor had not commenced within 24 hours of enrollment, labor was induced with oxytocin in both groups. Results: In this prospective randomized study, 74 pregnant women with PROM after the 37th week of gestation, prior to before the onset of active labor, were enrolled. Active labor began within 24 hours after enrollment in 54% of the control group and 77% of the intervention group (p = 0.036). The intervention group had a 3.42-hour shorter interval from randomization to delivery