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Journal of Perinatal Medicine

Official Journal of the World Association of Perinatal Medicine

Editor-in-Chief: Dudenhausen, MD, FRCOG, Joachim W.

Editorial Board: / Bancalari, Eduardo / Greenough, Anne / Genc, Mehmet R. / Chervenak, Frank A. / Chappelle, Joseph / Bergmann, Renate L. / Bernardes, J.F. / Bevilacqua, G. / Blickstein, Isaac / Cabero Roura, Luis / Carbonell-Estrany, Xavier / Carrera, Jose M. / D`Addario, Vincenzo / D'Alton, MD, Mary E. / Dimitrou, G. / Grunebaum, Amos / Hentschel, Roland / Köpcke, W. / Kawabata, Ichiro / Keirse, Marc J.N.C. / Kurjak M.D., Asim / Lee, Ben H. / Levene, Malcolm / Lockwood, Charles J. / Marsal, Karel / Makatsariya, Alexander / Nishida, Hiroshi / Papp, Zoltán / Pejaver, Ranjan Kumar / Pooh, Ritsuko K. / Reiss, Irwin / Romero, Roberto / Saugstad, Ola D. / Schenker, Joseph G. / Sen, Cihat / Seri, Istvan / Vetter, Klaus / Winn, Hung N. / Young, Bruce K. / Zimmermann, Roland

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1619-3997
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Volume 42, Issue 2

Issues

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

Armando Pintucci / Virginio Meregalli / Paolo Colombo / Angelo Fiorilli
Published Online: 2013-11-21 | DOI: https://doi.org/10.1515/jpm-2013-0017

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.

Keywords: Chorioamnionitis; expectant management; induction; neonatal infection; PROM

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About the article

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:


Received: 2013-01-24

Accepted: 2013-09-19

Published Online: 2013-11-21

Published in Print: 2014-03-01


Citation Information: Journal of Perinatal Medicine, Volume 42, Issue 2, Pages 189–196, ISSN (Online) 1619-3997, ISSN (Print) 0300-5577, DOI: https://doi.org/10.1515/jpm-2013-0017.

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