ABSTRACT
To assess the value of prophylaxis with penicillin in women with premature rupture
of membranes (PROM) and the long-term outcome of children born after prolonged PROM,
we studied 221 women with this condition. Penicillin (5 mu twice, 6 hours apart) was
given intravenously to 50 women and placebo to 51 women, whereas 76 comparable patients
were treated without penicillin or placebo. The time interval between PROM and delivery
ranged from 14 hours to 56 days. Chorioamnionitis occurred more frequently (p < 0.05)
among patients with placebo (14%) than among those treated with penicillin (2%). One
puerperal endometritis appeared in the placebo group compared with none in the penicillin
group. One newborn (1.7%) born to a mother with placebo prophylaxis developed septicemia,
compared with none in the penicillin group.
The outcomes of pregnancies complicated with PROM treated without penicillin or placebo
were comparable with those in the placebo group. In addition, we compared somatic
and psychomotor development of 159 children born to mothers with prolonged PROM (more
than 12 hours; mean, 5.6 days; range, 14 to 1344 hours) with those of 43 children
born at similar gestational age within 5 hours after PROM. No pulmonary sequelae could
be linked to the long time period between PROM and delivery, but infants born soon
after PROM more often (p < 0.05) had cerebral palsy (8 of 43,18.6%) than did infants
born after prolonged PROM (7 of 159; 4.4%). We conclude that, in cases with PROM,
penicillin prophylaxis decreases maternal and neonatal infectious morbidity and that
the long interval between PROM and delivery does not impairthe long-term outcome for
these children.
