OBJECTIVE: To identify predictors for prolonged interval from premature rupture of membranes (PROM) to spontaneous onset of labor in women presenting with PROM and low Bishop score at term. METHODS: A retrospective study of women presenting with PROM and Bishop score < 7 at term (≥37weeks) in a tertiary hospital (2013-14). Spontaneous onset of labor was defined as presence of regular uterine contractions and Bishop score ≥ 7. Women with interval from PROM to spontaneous onset of labor of <24hours (short interval group) were compared to those with interval ≥ 24 hours (prolonged interval group). Women who underwent induction of labor at < 24 hours from PROM were excluded. RESULTS: Among 625 women who met inclusion criteria, 155 (24.8%) had a prolonged interval to onset of labor. In multivariate analysis, prolonged PROM was associated with (OR, 95%CI) cervical dilatation (0.35, 0.24-0.52, p < 0.001), effacement (0.97, 0.96-0.99, p < 0.001) and uterine contraction (0.51, 0.32-0.80, p = 0.004). A multivariable prediction model including maternal age, parity, cervical dilatation and effacement, gestational age and neonatal birthweight was associated with an AUC of receiver-operator characteristic curve of 0.739 (0.631-0.847, p < 0.001) for predicting prolonged PROM. CONCLUSION: Uterine contractions and cervical examination parameters can be used for prediction of prolonged interval to spontaneous onset of labor in women with term PROM.
OBJECTIVE: To identify predictors for prolonged interval from premature rupture of membranes (PROM) to spontaneous onset of labor in women presenting with PROM and low Bishop score at term. METHODS: A retrospective study of women presenting with PROM and Bishop score < 7 at term (≥37weeks) in a tertiary hospital (2013-14). Spontaneous onset of labor was defined as presence of regular uterine contractions and Bishop score ≥ 7. Women with interval from PROM to spontaneous onset of labor of <24hours (short interval group) were compared to those with interval ≥ 24 hours (prolonged interval group). Women who underwent induction of labor at < 24 hours from PROM were excluded. RESULTS: Among 625 women who met inclusion criteria, 155 (24.8%) had a prolonged interval to onset of labor. In multivariate analysis, prolonged PROM was associated with (OR, 95%CI) cervical dilatation (0.35, 0.24-0.52, p < 0.001), effacement (0.97, 0.96-0.99, p < 0.001) and uterine contraction (0.51, 0.32-0.80, p = 0.004). A multivariable prediction model including maternal age, parity, cervical dilatation and effacement, gestational age and neonatal birthweight was associated with an AUC of receiver-operator characteristic curve of 0.739 (0.631-0.847, p < 0.001) for predicting prolonged PROM. CONCLUSION: Uterine contractions and cervical examination parameters can be used for prediction of prolonged interval to spontaneous onset of labor in women with term PROM.
Entities:
Keywords:
Bishop score; latency; outcome; predictors; premature rupture of membranes
Authors: George U Eleje; Euzebus C Ezugwu; Ifeanyichukwu U Ezebialu; Nnabuike O Ojiegbe; Richard O Egeonu; Chukwudi C Obiora; Chigozie G Okafor; Joseph I Ikechebelu; Ahizechukwu C Eke Journal: Int J Gynaecol Obstet Date: 2018-11-20 Impact factor: 4.447