Antibiotics for prelabour rupture of membranes at or near term

The value of routine antibiotic treatment for prelabour rupture of membranes is unknown. More research is needed.

RHL Commentary by A. Metin Gülmezoglu

EVIDENCE SUMMARY

The review evaluated the benefits and potential harms of administering antibiotics to women with prelabour rupture of the membranes at or near term.

Two trials with a total of 838 women were included. Both trials showed potential benefits in terms of reducing maternal infectious morbidity defined as chorioamnionitis and/or endometritis (relative risk [RR]: 0.43; 95% confidence interval [CI]: 0.23–0.82). There was inadequate evidence to reliably assess the effects on newborn outcomes particularly perinatal mortality (RR: 0.98; 95% CI: 0.14–6.89).

The trials used different parenteral antibiotic regimens (ampicillin + gentamycin and cefuroxime + clindamycin) and had different time thresholds for labour induction (12 hours and 24 hours).

Neither trial had allocation concealment. Newborn outcome assessment was blinded in one. The trials and the meta-analysis did not have sufficient statistical power to evaluate substantive outcomes reliably. The reviewers were appropriately cautious in their interpretation of the results and recommended more research.

The full RHL commentary also includes sections on:

Relevance
- Magnitude of the problem
- Applicability of the results
- Implementation of the intervention
Research
References

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This document should be cited as: A. Metin Gülmezoglu. Antibiotics for prelabour rupture of membranes at or near term: RHL commentary (last revised: 23 January 2006). The WHO Reproductive Health Library, No 9, Update Software Ltd, Oxford, 2006. www.rhlibrary.com