Induced Labor Not Safer

Newborn infection risk is low and induction not necessary when water breaks early

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) If your water breaks before you're in labor or due to give birth, infection risk for your baby is low, and the best course of action may be to just wait it out under a doctor's observation.

Women whose membranes rupture between 34 and 37 weeks of pregnancy won't necessarily reduce the risk of infection or breathing problems in their newborn if their labor is induced.

"Immediately call your OB/GYN if your water breaks early."

A study led by David van der Ham, of the Obstetrics and Gynecology department of Maastricht University Medical Center in the Netherlands, looked at outcomes of babies born to women who were and were not induced following an early rupture of membranes.

The rupture of membranes is commonly called a woman's "water breaking" because the amniotic sac bursts and releases the amniotic fluid.

His team had previously studied 532 pregnant woman and discovered the risk of infection was low among babies born to mothers with an early rupture of membranes, regardless of whether they had been induced.

To confirm their findings, van der Ham's team ran another randomized trial with 200 women across 60 hospitals in the Netherlands between December 2009 and January 2011.

Each participating woman did not enter labor more than 24 hours after her water broke between the 34th and 37th week of pregnancy.

Half the women were induced, and the other half underwent "expectant management," where they were closely monitored by the hospital staff.

The researchers were looking to see how many newborns had "neonatal sepsis," where their blood tests positive for an infection or they exhibit symptoms of infection.

Three of the babies in the induced group had infections compared to five babies with infection in the group of mothers who were monitored instead of being induced - not a significant difference between the two methods.

There were also no significant differences between the number of babies who ended up being delivered by c-section across the two groups.

There was a slightly higher rate of inflammation of the fetal membranes, which usually results in a fever for the pregnant mother, in the group who were monitored instead of induced.

"This study suggests that expectant management (watchful waiting) should be performed with delivery at 37 weeks unless there are mitigating factors such as maternal fever or neonatal compromise arise," Dr. Kevin Gordon, M.D., told dailyRx. Gordon is an obstetrician and gynecologist from Arlington, Texas, who was not associated with this study.

The study was presented February 9 at the Society for Maternal-Fetal Medicine's annual meeting, The Pregnancy Meeting, in Dallas, TX. No information was available regarding the study's funding or financial disclosures of the authors.

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Last Updated:
February 16, 2012