Expectant Management of Preterm Ruptured Membranes: Effects of Antimicrobial Therapy

OBJECTIVE:To determine whether the addition of broadspectrum antimicrobial therapy to traditional expectant management improves pregnancy outcome in patients with premature rupture of membranes (PROM) remote from term. METHODS:Patients with preterm PROM before 34 weeksʼ gestation who were not in labor and had no signs of infection or fetal distress were randomized to one of two study groups1) expectant management alone and 2) expectant management plus antimicrobial therapy. Women in the latter group received intravenous ampicillin, gentamicin, and clindamycin for 24 hours, followed by amoxicillin plus clavulanic acid orally for 7 days. Other than antibiotic use, management of the two groups was identical. RESULTS:Significantly more women (P