[Prostaglandins in the induction of labor at term with premature rupture of fetal membranes].

A prospective, randomized study included 389 pregnant women with normal pregnancy, gestational age of 37 weeks (259 days) in whom the delivery started by premature rupture of fetal membranes and without labor pains 6 or more hours after rupture of fetal membranes. The Bishop score was < or = 6 and there were no clinical or laboratory signs of infection before induction. The first group (n = 219) included pregnant women at term with premature rupture of fetal membranes and unfavourable pelvic score in whom labor was induced by intracervical dinoprostone. The second-control group (n = 170) included pregnant women at term with premature rupture of fetal membranes and unfavorable pelvic score in whom delivery was induced by oxytocin infusion. In a 6 hour interval from the beginning of induction 61.64% women from the I group and 40.00% from the control group had a pelvic score > or = 7, (p < 0.05). After 12 hours the Bishop score was > or = 7 in 89.94% of women from the I group and 61.18% from the II-control group (p < 0.03). 63.34% of women, in whom labor was induced by intracervical application of dinoprostone, had an additional oxytocin induction. 82.18% of women from the first group and 62.25% from the second group (p < 0.05) had vaginal delivery with reduced activity of the uterus (p < 0.05) and significantly decreased number of irregular labor pains (p < 0.05) with hypertonia, hypercontraction and frequent contractions. In the first group the mean time of induction was 8.12 +/- 5.51 hours, while in the second-control group it was 10.83 +/- 7.34 hours (p < 0.01). In the group of deliveries induced by dinoprostone incidence of puerperal induction was 1.01% and 5.93% in the control group. Neonatal infection occurred in 3.19% of newborns in the first group and in 11.18% in the second group. 5.05% of newborns from the first group and 9.41% from the control group suffered from perinatal trauma and anoxia. In the first group the total perinatal morbidity was 10.43% and 31.18% in the second group (p < 0.05).