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Induction at 32 weeks possible action for expectant moms with premature membrane rupture

ROCHESTER, Minn. -- A new Mayo Clinic study of pregnant women who experience early membrane rupture has found induction of labor at 32 weeks gestation to be a viable option.

"Our findings show us that mothers and babies do just as well when the mothers are induced at 32 weeks rather than later at 34 to 36 weeks, the current standard of care," says Brian Brost, M.D., Mayo Clinic high-risk pregnancy specialist and study co-author. "So, why take the risk of infection in keeping the baby in mom longer if there's no difference in how the babies do?"

In cases of prolonged early membrane rupture, obstetricians must do a careful dance to get the unborn baby as close as possible to term, while avoiding the increased risk of infection. Mothers in this situation are at risk for infection of the membranes surrounding the baby, and such infection can prompt premature delivery or infection of the uterus after delivery. Unborn babies are at risk for a host of infections, including one that can lead to cerebral palsy, from bacteria entering the baby's bloodstream via the membrane rupture.

"The idea is to deliver the mother before the baby gets an infection," says Dr. Brost. "The dilemma is trying to deliver later so baby can get older but before an infection can set in."

The study found that infections in both mom and baby were significantly lower in mothers experiencing membrane rupture when they opted for induction at 32 weeks pregnancy rather than waiting for spontaneous labor. In addition, hospital stay for the newborn was considerably shorter in cases where the mother was induced.

"After 32 weeks, it's unusual for a baby to have lifelong problems," says Dr. Brost. "If the baby is infected due to the membrane rupture between 32 and 34 weeks, however, the long-term outcome can be worse."

The Mayo Clinic researchers indicate their findings show induction at 32 weeks gestation is an option for women with prolonged premature me
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Contact: Lisa Lucier
newsbureau@mayo.edu
507-284-5005
Mayo Clinic
11-Feb-2005


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