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Perinatal outcome in women with prolonged premature rupture of membranes at term undergoing labor induction

Archives of Gynecology and Obstetrics volume 294, pages 1125–1131 (2016)Cite this article

Abstract

Purpose

We aimed to evaluate perinatal outcome in women with prolonged (>24 h) premature rupture of membranes (PROM) undergoing induction of labor (IoL).

Methods

We retrospectively assessed all women presenting with term (≥37 weeks) PROM and Bishop-score <7 in a tertiary hospital (2012–14). Women without spontaneous onset of labor <24 h from PROM underwent Prostaglandin E2 (PGE2) IoL and were compared to women with low Bishop-score who developed spontaneous onset of labor <24 h. Women with IoL at <24 h from PROM, women presenting in active labor at admission or women who did not attempt vaginal delivery were excluded.

Results

Among 15,563 deliveries 1,171 (8.2 %) admitted with term PROM. Of them, 625 (53 %) were eligible; 155 (24.8 %) in the induction group and 470 (75.2 %) served as comparison group. No significant difference was found between the groups regarding maternal age, parity and obstetrical complications. Women in the induction group were at increased risk for Cesarean section (CS) (OR 8.27, CI 1.30–52.36, p = 0.025) and especially CS due to labor dystocia (2.97, 1.20–7.36, p = 0.018). The rate of neonatal complications was comparable between the groups.

Conclusion

Women undergoing IoL for prolonged term PROM were at increased risk for CS compared to those with spontaneous onset of labor. However, neonatal outcome was comparable between the groups.

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References

  1. American College of Obstetricians and Gynecologists (2013) Practice bulletins No. 139: premature rupture of membranes. Obstet Gynecol 122:918–930

    Article  Google Scholar 

  2. Gunn GC, Mishell DR Jr, Morton DG (1970) Premature rupture of the fetal membranes: a review. Am J Obstet Gynecol 106:469–483

    CAS  Article  PubMed  Google Scholar 

  3. Grant J, Keirse MJNC (1989) Prelabour rupture of the membranes at term. In: Chalmers I, Enkin M, Keirse MJNC (eds) Effective care in pregnancy and childbirth, vol 2. Childbirth. Oxford University Press, Oxford, England, pp 1112–7

  4. Dare MR, Middleton P, Crowther CA, Flenady VJ, Varatharaju B (2006) Planned early birth versus expectant management (waiting) for prelabour rupture of membranes at term (37 weeks or more). Cochrane Database Syst Rev 25

  5. Mozurkewich EL, Wolf FM (1997) Premature rupture of membranes at term: a meta-analysis of three management schemes. Obstet Gynecol 89:1035–1043

    CAS  Article  PubMed  Google Scholar 

  6. Hannah ME, Ohlsson A, Farine D et al (1996) Induction of labor compared with expectant management for prelabor rupture of the membranes at term. TERMPROM Study Group. N Engl J Med 334:1005–1010

    CAS  Article  PubMed  Google Scholar 

  7. Keirse MJ, Ottervanger HP, Smit W (1996) Controversies: prelabor rupture of the membranes at term: the case for expectant management. J Perinat Med 24:563–572

    CAS  PubMed  Google Scholar 

  8. Seaward PG, Hannah ME, Myhr TL, Farine D et al (1997) International multicentre term prelabor rupture of membranes study: evaluation of predictors of clinical chorioamnionitis and postpartum fever in patients with prelabor rupture of membranes at term. Am J Obstet Gynecol 177:1024–1029

    CAS  Article  PubMed  Google Scholar 

  9. Tan BP, Hannah ME (2000) Prostaglandins versus oxytocin for prelabour rupture of membranes at term. Cochrane Database Syst Rev

  10. Lin MG, Nuthalapaty FS, Carver AR, Case AS, Ramsey PS (2005) Misoprostol for labor induction in women with term premature rupture of membranes: a meta-analysis. Obstet Gynecol 106:593–601

    CAS  Article  PubMed  Google Scholar 

  11. Hofmeyr GJ, Gülmezoglu AM, Pileggi C (2010) Vaginal misoprostol for cervical ripening and induction of labour. Cochrane Database Syst Rev 6

  12. Thomas J, Fairclough A, Kavanagh J, Kelly AJ (2014) Vaginal prostaglandin (PGE2 and PGF2a) for induction of labour at term. Cochrane Database Syst Rev 19:6

    Google Scholar 

  13. Pevzner L, Rayburn WF, Rumney P, Wing DA (2009) Factors predicting successful labor induction with dinoprostone and misoprostol vaginal inserts. Obstet Gynecol 114:261

    CAS  Article  PubMed  Google Scholar 

  14. Verani JR, McGee L, Schrag SJ, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC) (2010) Prevention of perinatal group B streptococcal disease—revised guidelines from CDC 2010. MMWR Recomm Rep 59:1–36

    PubMed  Google Scholar 

  15. American College of Obstetricians and Gynecologists (2010) Practice bulletin no. 116: management of intrapartum fetal heart rate tracings. Obstet Gynecol 116:1232–1240

    Article  Google Scholar 

  16. Macones GA, Hankins GD, Spong CY, Hauth J, Moore T (2008) The 2008 National Institute of Child Health and Human Development workshop report on electronic fetal monitoring: update on definitions, interpretation, and research guidelines. Obstet Gynecol 112:661–666

    Article  PubMed  Google Scholar 

  17. Mahmood TA, Dick MJW (1995) A randomized trial of management of pre-labor rupture of membranes at term in multiparous women using vaginal prostaglandin gel. Obstet Gynecol 85:71–74

    CAS  Article  PubMed  Google Scholar 

  18. Natale R, Milne JK, Campbell MK, Potts PGG, Webster K, Halinda E (1994) Management of premature rupture of membranes at term: randomized trial. Am J Obstet Gynecol 171:936–939

    CAS  Article  PubMed  Google Scholar 

  19. Ottervanger HP, Holm JP, Keirse MJNC (1992) A randomized trial of expectant vs active management for prelabour rupture of the membranes at term. J Perinat Med 20:223

    Article  Google Scholar 

  20. Shalev E, Peleg D, Eliyahu S, Nahum Z (1995) Comparison of 12- and 72-h expectant management of premature rupture of membranes in term pregnancies. Obstet Gynecol 85:766–768

    CAS  Article  PubMed  Google Scholar 

  21. Wagner MV, Chin VP, Peters CJ, Drexler B, Newman LA (1989) A comparison of early and delayed induction of labour with spontaneous rupture of membranes at term. Obstet Gynecol 74:93–97

    CAS  PubMed  Google Scholar 

  22. Cammu H, Martens G, Ruyssinck G, Amy JJ (2002) Outcome after elective labor induction in nulliparous women: a matched cohort study. Am J Obstet Gynecol 186:240

    Article  PubMed  Google Scholar 

  23. Luthy DA, Malmgren JA, Zingheim RW (2004) Cesarean delivery after elective induction in nulliparous women: the physician effect. Am J Obstet Gynecol 191:1511

    Article  PubMed  Google Scholar 

  24. Mizrachi Y, Levy M, Bar J, Kovo M (2016) Induction of labor in nulliparous women with unfavorable cervix: a comparison of Foley catheter and vaginal prostaglandin E2. Arch Gynecol Obstet (Epub ahead of print)

  25. Vahratian A, Zhang J, Troendle JF et al (2005) Labor progression and risk of cesarean delivery in electively induced nulliparas. Obstet Gynecol 105:698

    Article  PubMed  Google Scholar 

  26. Ehrenthal DB, Jiang X, Strobino DM (2010) Labor induction and the risk of a cesarean delivery among nulliparous women at term. Obstet Gynecol 116:35

    Article  PubMed  Google Scholar 

  27. Lavery JP, Miller CE, Knight RD (1982) The effect of labor on the rheologic response of chorioamniotic membranes. Obstet Gynecol 60

  28. McLaren J, Taylor DJ, Bell SC (1999) Increased incidence of apoptosis in non-labour-affected cytotrophoblast cells in term fetal membranes overlying the cervix. Hum Reprod 14

  29. El Khwad M, Stetzer B, Moore RM et al (2005) Term human fetal membranes have a weak zone overlying the lower uterine pole and cervix before onset of labor. Biol Reprod 72

  30. Abrahams VM, Potter JA, Bhat G, Peltier MR, Saade G, Menon R (2013) Bacterial modulation of human fetal membrane Toll-like receptor expression. Am J Reprod Immunol 69:33–40

    CAS  Article  PubMed  Google Scholar 

  31. Mercer BM (2003) Preterm premature rupture of the membranes. Obstet Gynecol 101:178–193

    PubMed  Google Scholar 

  32. Duff P, Sanders R, Gibbs RS (1983) The course of labor in term patients with chorioamnionitis. Am J Obstet Gynecol 147:391–395

    CAS  Article  PubMed  Google Scholar 

  33. Gomez-Lopez N, Hernandez-Santiago S, Lobb AP, Olson DM, Vadillo-Ortega F (2013) Normal and premature rupture of fetal membranes at term delivery differ in regional chemotactic activity and related chemokine/cytokine production. Reprod Sci. 20:276–284

    Article  PubMed  Google Scholar 

  34. Gómez López N, Estrada Gutiérrez G, Beltrán Montoya J, Espejel Núñez A, Vadillo Ortega F (2008) Extracellular matrix metalloproteases profile identification in chorioamniotic membranes of term and preterm pregnancies through soluble microarrays. Ginecol Obstet Mex 76:32–7

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Helen Schneider Hospital for Women, Rabin Medical Center, 49100, Petach Tikva, Israel

    Eran Ashwal, Eyal Krispin, Amir Aviram, Rinat Gabby-Benziv & Arnon Wiznitzer

  2. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Eran Ashwal, Eyal Krispin, Amir Aviram, Ella Aleyraz, Rinat Gabby-Benziv, Arnon Wiznitzer, Yariv Yogev & Liran Hiersch

Authors
  1. Eran Ashwal
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  2. Eyal Krispin
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  3. Amir Aviram
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Correspondence to Eyal Krispin.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required. This article does not contain any studies with animals performed by any of the authors.

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Ashwal, E., Krispin, E., Aviram, A. et al. Perinatal outcome in women with prolonged premature rupture of membranes at term undergoing labor induction. Arch Gynecol Obstet 294, 1125–1131 (2016). https://doi.org/10.1007/s00404-016-4126-6

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  • DOI: https://doi.org/10.1007/s00404-016-4126-6

Keywords

  • Induction of labor
  • Cesarean section
  • Outcome
  • Premature rupture of membranes