Previable and periviable rupture of membranes is associated with significant morbidity for the pregnant patient. For those who have a choice of options and undergo active management, it is not known how the risks of induction of labor compare with those for dilation and evacuation (D&E). We performed a retrospective cohort study of patients with rupture of membranes between 14 0/7 and 23 6/7 weeks of gestation who opted for active management. Adverse events (52.2% vs 16.9%, P<.01) and time to uterine evacuation greater than 24 hours (26.7% vs 9.6%, P=.01) were more common among patients undergoing induction of labor. In a multivariable regression, induction of labor was an independent risk factor for complications (odds ratio 5.70, 95% CI, 2.35-13.82) compared with D&E. Severe complications were rare across both groups (4.4% for patients undergoing induction vs 2.6% for D&E, P=.63). Given the differing risks by termination method, access to D&E is an important treatment option for this patient population.

中文翻译：

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引产后的结果与扩张和清宫术治疗中期胎膜破裂的结果进行比较。

预产期和预产期胎膜破裂与妊娠患者的显着发病率相关。对于那些有选择并接受积极管理的人来说，目前尚不清楚引产的风险与扩张和清宫 (D&E) 的风险相比如何。我们对妊娠 14 0/7 至 23 6/7 周期间胎膜破裂并选择积极治疗的患者进行了一项回顾性队列研究。在接受引产的患者中，不良事件（52.2% vs 16.9%，P<.01）和排宫时间超过 24 小时（26.7% vs 9.6%，P=.01）更为常见。在多变量回归中，与 D&E 相比，引产是并发症的独立危险因素（比值比 5.70，95% CI，2.35-13.82）。两组患者均很少出现严重并发症（引产患者为 4.4%，D&E 患者为 2.6%，P=0.63）。鉴于终止方法的风险不同，接受 D&E 是该患者群体的重要治疗选择。