{Reference Type}: Journal Article
{Title}: Uncertain prelabor rupture of membranes at term and associated delivery outcomes.
{Author}: Geron Y;Rozner Negrin N;Matot R;Hendin N;Danieli-Gruber S;Shmueli A;Hadar E;
{Journal}: Int J Gynaecol Obstet
{Volume}: 0
{Issue}: 0
{Year}: 2024 Jun 14
{Factor}: 4.447
{DOI}: 10.1002/ijgo.15735
{Abstract}: OBJECTIVE: To determine whether equivocal prelabor rupture of membranes (PROM) cases are associated with adverse outcomes.
METHODS: A retrospective study was conducted in a tertiary medical center between July 2012 and March 2022. The cohort comprised all women diagnosed with term PROM (≥37 gestational weeks), divided into two groups. (1) Certain PROM-suggestive history of a watery vaginal discharge confirmed by visualization of fluid leaking from the cervix or pooling in the vagina on speculum examination. (2) Uncertain PROM-suggestive history of a watery vaginal discharge not supported by speculum examination. All patients were hospitalized and gave birth spontaneously or following either expectant management for up to 24 h from PROM or induction. The primary outcome measure was cesarean delivery (CD) rate. Secondary outcome measures were adverse maternal/neonatal events.
RESULTS: Of the 2012 women included in the study, 1750 had certain PROM and 262 uncertain PROM. CD rate was 5.8% in the certain PROM group and 8.8% in the uncertain PROM group; the difference was not statistically significant (P = 0.074). There was a significant between-group difference in the rate of CD due to failed induction on univariate analysis (0.69% vs 2.67%, respectively, P = 0.007), but it was not maintained on multivariate logistic regression (odds ratio 0.37, 95% confidence interval: 0.12-1.17). Other maternal and neonatal outcomes were similar in the two groups.
CONCLUSIONS: Our findings indicate that following the same management guidelines for equivocal cases of ruptured membranes as for confirmed cases of term PROM did not compromise maternal or fetal outcomes.