Antibiotic Prophylaxis in Prelabor Rupture of Membranes at Term

Antibiotic Prophylaxis in Prelabor Rupture of Membranes at Term - a Randomized Controlled Trial

The aims of this study are to determine whether antibiotics administered routinely in women presenting with premature rupture of membranes later than the 37+0 weeks of gestation can alter the rate of maternal and neonatal infection and to compare these rates between prompt (< 12 hour) and delayed (≥ 12 hour) induction in the group of patients not submitted to antibiotic prophylaxis.

Inclusion Criteria:

• term (≥ 37+0 weeks) singleton pregnancy
• a vertex presentation
• ruptured membranes for less than 12 hours
• negative Group B Streptococcus (GBS) culture performed between 35 and 37 weeks

Exclusion Criteria:

• active labor
• absence of GBS culture or indication for GBS antibiotic prophylaxis (such as maternal GBS colonization between 35 and 37 weeks, GBS bacteriuria, prior infant with GBS sepsis)
• contraindication to expectant management (such as fetal distress, meconium staining of the amniotic fluid or chorioamnionitis) or to vaginal delivery