Nonintervention in premature rupture of the amniotic membranes

One hundred and forty-one instances of premature rupture of the amniotic membranes (PROM), between 25 and 36 weeks gestation and with duration of PROM greater than six hours, were managed by bedrest, observation and no obstetric intervention. Delivery was allowed if the patient had spontaneous labor develop, and delivery was initiated for chorioamnionitis or fetal distress. The perinatal mortality was 25 of 148 infants delivered (168 of 1,000 births). The majority of neonatal deaths (64 per cent) were attributable to complications of prematurity. Neonatal sepsis was uncommon as a cause of death (0.16 per cent). Results indicate that the natural history of PROM is associated with a low incidence of serious maternal and fetal infections and that prematurity is the most serious problem.