open access

Vol 92, No 7 (2021)
Research paper
Published online: 2021-03-31
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Early planned labor induction vs expectant management in late preterm pre-labor rupture of membranes: maternal and neonatal outcomes

Inshirah Sgayer12, Karina Naskovica2, Raneen Abu Shaqara2, Marwan Odeh12, Jacob Bornstein12, Maya Frank Wolf12
DOI: 10.5603/GP.a2021.0038
·
Pubmed: 33844257
·
Ginekol Pol 2021;92(7):498-504.
Affiliations
  1. The Azrieli faculty of Medicine, Bar-Ilan University, Safed, Israel
  2. Galilee Medical Center, Nahariya, Israel

open access

Vol 92, No 7 (2021)
ORIGINAL PAPERS Obstetrics
Published online: 2021-03-31

Abstract

Objectives: To compare expectant management with early planned labor induction in pregnancies complicated by late preterm pre-labor rupture of membranes (PPROM).
Material and methods: A retrospective file review was conducted in a single tertiary center from January 2015 to Sep-tember 2019. Singleton pregnancies complicated by late PPROM at 34–36 completed weeks of gestation were enrolled. We compared maternal and neonatal complications between expectant management and early planned labor induction.
Results: We retrospectively assigned 41 women to the expectant management group and 39 to the early planned labor induction group. No difference was found in the mode of delivery between the groups. Women in the expectant manage-ment group had a longer antepartum hospital stay compared with the induction group (median of three versus one day, p < 0.01). Neonates were delivered at a more advanced gestational age in the expectant management group compared with that in the induction group (35 5/7 versus 35 2/7 weeks, p < 0.01). In the induction group, 74.4% of the neonates were admitted to the intensive care unit (ICU), and 66.7% received antibiotics compared with 51.2% of neonates admitted to ICU and 29.3% receiving antibiotics in the expectant management group (p = 0.04 and p < 0.01, respectively).
Conclusions: In pregnancies complicated by late PPROM, early labor induction was associated with a shorter antepartum maternal hospital stay but a higher neonatal ICU admission rate and more frequent antibiotic administration than expect-ant management. We consider expectant management to be an acceptable alternative to early labor induction in PPROM.

Abstract

Objectives: To compare expectant management with early planned labor induction in pregnancies complicated by late preterm pre-labor rupture of membranes (PPROM).
Material and methods: A retrospective file review was conducted in a single tertiary center from January 2015 to Sep-tember 2019. Singleton pregnancies complicated by late PPROM at 34–36 completed weeks of gestation were enrolled. We compared maternal and neonatal complications between expectant management and early planned labor induction.
Results: We retrospectively assigned 41 women to the expectant management group and 39 to the early planned labor induction group. No difference was found in the mode of delivery between the groups. Women in the expectant manage-ment group had a longer antepartum hospital stay compared with the induction group (median of three versus one day, p < 0.01). Neonates were delivered at a more advanced gestational age in the expectant management group compared with that in the induction group (35 5/7 versus 35 2/7 weeks, p < 0.01). In the induction group, 74.4% of the neonates were admitted to the intensive care unit (ICU), and 66.7% received antibiotics compared with 51.2% of neonates admitted to ICU and 29.3% receiving antibiotics in the expectant management group (p = 0.04 and p < 0.01, respectively).
Conclusions: In pregnancies complicated by late PPROM, early labor induction was associated with a shorter antepartum maternal hospital stay but a higher neonatal ICU admission rate and more frequent antibiotic administration than expect-ant management. We consider expectant management to be an acceptable alternative to early labor induction in PPROM.

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Keywords

cesarean section; chorioamnionitis; labor induction; neonatal respiratory distress syndrome; premature rupture of membrane (pregnancy)

About this article
Title

Early planned labor induction vs expectant management in late preterm pre-labor rupture of membranes: maternal and neonatal outcomes

Journal

Ginekologia Polska

Issue

Vol 92, No 7 (2021)

Article type

Research paper

Pages

498-504

Published online

2021-03-31

DOI

10.5603/GP.a2021.0038

Pubmed

33844257

Bibliographic record

Ginekol Pol 2021;92(7):498-504.

Keywords

cesarean section
chorioamnionitis
labor induction
neonatal respiratory distress syndrome
premature rupture of membrane (pregnancy)

Authors

Inshirah Sgayer
Karina Naskovica
Raneen Abu Shaqara
Marwan Odeh
Jacob Bornstein
Maya Frank Wolf

References (17)
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