Management of Rupture of Membranes at Term

Induction of Labor

• Antibiotic prophylaxis for Group B Streptococcus is indicated after 18 hours of membrane rupture regardless of other risk factors 1
• Oxytocin should be administered intravenously to initiate or improve uterine contractions for early vaginal delivery, as recommended by guidelines similar to those from the Centers for Disease Control and Prevention 2
• If spontaneous rupture of membranes occurs before or early during labor, interventions to decrease the interval to delivery, such as oxytocin administration, should be considered, as suggested by guidelines from the Centers for Disease Control and Prevention 3

Monitoring and Patient Education

• Assess for maternal fever, uterine tenderness, fetal tachycardia, and purulent or malodorous vaginal discharge, and monitor maternal vital signs and fetal heart rate, as recommended by the American College of Obstetricians and Gynecologists 4
• Monitor for signs of infection and consider laboratory evaluation for leukocytosis, and patients should be instructed to report fever, contractions, vaginal bleeding, discolored discharge, and abdominal pain, as advised by the American College of Obstetricians and Gynecologists 1