Premature rupture of the membranes at term: time to reevaluate the management

Dana Sadeh-Mestechkin, Nivin Samara, Amir Wiser, Ofer Markovitch, Gil Shechter-Maor, Tal Biron-Shental

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To compare maternal and neonatal outcomes in induced vs. expectant management of term PROM. Methods: This retrospective study included patients with term PROM. A total of 325 were enrolled: 213 managed expectantly and 112 induced at admission and matched according to gestational age. Expectant management group patients were allowed to defer labour induction up to 48 h. Primary outcome measures were maternal or foetal signs of infection (chorioamnionitis, early neonatal sepsis or postpartum endometritis) and prolonged maternal hospitalization. Secondary outcome was caesarean delivery rate. Results: All group characteristics were comparable except that expectant management included more nulliparous women. Women managed expectantly had a higher rate of prolonged hospitalization [15 (7 %) vs. 2 (1.8 %); P = 0.043] as an indication of maternal complications, compared to induction management. They also had a higher rate of caesarean delivery [34 (16.4 %) vs. 8 (7.1 %), respectively; P = 0.024]. Adjustment for parity did not change the results. Early neonatal outcomes were similar between groups. Conclusions: Expectant management increases the likelihood of caesarean delivery and prolonged maternal hospitalization. This should be considered when advising patients with term PROM regarding labour induction.

Original languageEnglish
Pages (from-to)1203-1207
Number of pages5
JournalArchives of Gynecology and Obstetrics
Volume294
Issue number6
DOIs
StatePublished - 1 Nov 2016

Keywords

  • Caesarean delivery
  • Chorioamnionitis
  • Premature rupture of membranes (PROM)
  • Term delivery

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