Premature rupture of the membranes

In a consecutive series of 93 patients with premature rupture of the membranes at 20 to 34 weeks of gestation, the perinatal mortality was 23.7%. One-quater of the deaths were due to lethal congenital abnormalities, 18% were due to intrauterine infection, and 36% resulted from severe respiratory distress syndrome (RDS). Corticosteroid therapy increased the risk of incompetence, and did not reduce the incidence or severity of RDS. Almost one-third of the patients were delivered within 48 hours of membrane rupture; however, short-term treatment with salbutamol was able to delay the delivery for at least six days in 5 of the 13 patients to whom it was given. As postponement of delivery for days or weeks after the membranes have ruptured reduces the incidence and severity of Rds, this therapy may well have a place in the treatment of this condition.