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

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.