A randomised controlled trial of immediate delivery versus expectant care in women with ruptured membranes close to term

早产胎膜早破（PPROM）并发症占所有妊娠的1-2%，是所有早产的40%的原因。在离足月较远的妊娠期，待产管理是适当的，以使胎儿成熟。当PPROM并发症妊娠接近足月时，早产的风险较低，对婴儿败血症的风险变得更重要。该试验将提供一级证据，据此确定对这些妇女的最佳管理。如果能够证明在这种临床情况下提前计划分娩与较低的孕产妇和新生儿发病率有关，这将改变目前的国家做法。这项研究的结果也将具有重要的资源意义，因为接近足月的PPROM是产前入院的常见指征。该研究还允许从两种不同的管理策略中详细评估与新生儿护理相关的成本。分析立即分娩的临床和经济后遗症，而不是预期的管理，将有助于制定明智的决定和指导方针。

Preterm premature rupture of the membranes (PPROM) complicates 1-2% of all pregnancies and is the cause of 40% of all preterm births . At gestations remote from term expectant management is appropriate to allow fetal maturation. When PPROM complicates pregnancies closer to term the risks of prematurity are lower and the risk to the infant of sepsis becomes of greater significance. This trial will provide level 1 evidence from which to determine the optimum management of these women. If it can be demonstrated that early planned delivery in this clinical situation is associated with less maternal and neonatal morbidity this will change current national practice. The findings of the study will also have significant resource implications as PPROM close to term is a frequent indication for antenatal admission. The study also allows for a detailed assessment of the costs associated with the care of the neonate from two different management strategies. Analysis of the clinical and economic sequelae of immediate delivery as opposed to expectant management will enable informed decisions and guidelines to be formulated.