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PROM at termFrom: Nal55prod@aol.comSat Apr 27 11:52:18 1996
In the recent NEJM article on PROM at term there were four perinatal deaths that were potentially preventable in the groups randomized to conservative therapy vs none in the groups randomized to immediate induction with PGE2 or oxytocin. Although these numbers were not significantly different when groups are compared as a whole, a large nomber of women in the conservatively managed groups went into labor shortly after admission. If the smaller number of women who did not go into labor is considered the risk of perinatal mortality with conservative management is increased. Given the lack of difference in c-section rates, the increased maternal satisfaction with induction, the loss of the barrier to infection, and the loss of the amniotic fluid cushion to cord compression, I fail to see the advantages of consevative management of PROM at term. Jay Naliboff, MD Farmington, Me.
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