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Licensed Unlicensed Requires Authentication Published by De Gruyter November 21, 2013

Premature rupture of membranes at term in low risk women: how long should we wait in the “latent phase”?

  • Armando Pintucci EMAIL logo , Virginio Meregalli , Paolo Colombo and Angelo Fiorilli

Abstract

Aim: How long the waiting time may be for the onset of spontaneous labor after prelabor rupture of fetal membranes at term (tPROM) remains controversial.

Methods: The study is an observational cohort study of 6032 women. All obstetric patients with no obstetric risk factors, other than tPROM, were included. The analysis focused on the onset of labor (spontaneous vs. induction), maternal morbidity [cesarean section (CS) and chorioamnionitis] and neonatal morbidity (suspected infection) related to a policy of waiting for the onset of spontaneous labor within 48 h of tPROM.

Results: tPROM was experienced by 1439 women. A careful clinical management shows a very low rate of clinical chorioamnionitis (2.3%) and neonatal infection rate (2.8%), even after 24 h from tPROM. The overall incidence of CS was 4.5%. Furthermore, a policy of waiting for the onset of spontaneous labor within 48 h of tPROM is associated with a low rate of CS, less than induced labor (OR=1.76; 95% confidence interval 1.03–3.02; P<0.004).

Conclusions: Fetal and/or maternal morbidity in tPROM women may not increase if there is a strict analysis of maternal and or fetal risk factors added to a careful clinical management. Moreover, it may be useful to wait for spontaneous labor in order to enhance the patient’s chance of vaginal delivery.


Corresponding author: Armando Pintucci, Department of Obstetrics and Gynecology, V. Emanuele III Hospital, via Mosè Bianchi 9, 20831 Carate Brianza, Italy, Tel.: +39-3405088670, E-mail:

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The authors stated that there are no conflicts of interest regarding the publication of this article.

Received: 2013-1-24
Accepted: 2013-9-19
Published Online: 2013-11-21
Published in Print: 2014-3-1

©2014 by Walter de Gruyter Berlin Boston

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