OBJECTIVE: We postulated that recent cocaine use is common among patients with preterm (<37 weeks) rupture of the membranes and that cocaine users have shorter latency periods before the onsent of labor and delivery compared with those without recent cocaine use. STUDY DESIGN: A urine toxicologic screen was performed on all patients admitted with preterm rupture of the membranes. Patients were managed expectantly, without tocolytics, antibiotics, or steroids. RESULTS: One hundred three patients were enrolled; 71 had negative screens and 19 were positive for cocaine alone. Cocaine-positive women were significantly older and had more advanced cervical dilatation at admission and a significantly shorter latency period from rupture of membranes to labor and delivery. CONCLUSION: Preterm rupture of the membranes associated with recent cocaine use is characterized by advanced cervical dilatation at admission and a shorter latency period to labor and delivery.