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As the interval between rupture of the fetal membranes at term and delivery increases, so may the risk of fetal and maternal infection. It is not known whether inducing labor will reduce this risk or whether one method of induction is better than another.

We studied 5041 women with prelabor rupture of the membranes at term. The women were randomly assigned to induction of labor with intravenous oxytocin; induction of labor with vaginal prostaglandin E₂ gel; or expectant management for up to four days, with labor induced with either intravenous oxytocin or vaginal prostaglandin E₂ gel if complications developed. The primary outcome was neonatal infection. Secondary outcomes were the need for cesarean section and women's evaluations of their treatment.

The rates of neonatal infection and cesarean section were not significantly different among the study groups. The rates of …