Skip to main content
SMFM 2024 Pregnancy Meeting Main banner
Final Program


Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Presentation Icons
Additional registration fee required
Additional registration fee required
Faculty have requested this content not be shared on social media
Faculty have requested this content not be shared on social media
CME Credit Offered
CME Credit Offered
Poster Icons
Foundation Awardee
Foundation Awardee
No Social Media
No Social Media
Back
Q&A

Infectious Diseases

Poster Session 1

(97) Induction of labor at 12 vs. 24-hours for prelabor rupture of membranes: a retrospective study

Tuesday, February 13, 2024
10:30 AM – 12:00 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level

    Presenting Author(s)

  • Raneen Abu Shqara, MD

    Resident
    Galilee Medical Center and Azrieli Faculty of Medicine Bar-Ilan University
    Nahariya, HaZafon, Israel

    • Coauthor(s)

  • LR

    Liron Rosso, MD

    Galilee Medical Center
    Nahariya, HaZafon, Israel

  • LL

    Lior Lowenstein, MD

    Galilee Medical Center, Nahariya, Israel Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel
    Naharyia, HaZafon, Israel

    • Primary Author(s)

  • Maya Frank Wolf, MD (she/her/hers)

    Director of Maternal-Fetal Unit
    Galilee Medical Center, Nahariya, and Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel
    Nahariya, HaZafon, Israel

Objective: The management of term prelabor rupture of membrane (PROM) is controversial. As spontaneous labor occurs in 60% and 95% of women at 12 and 24-h post PROM, respectively, we changed our department protocol from induction at 12 to 24-h following PROM. We aimed to investigate maternal and neonatal morbidity according to the two induction protocols.

Study Design: This retrospective study was conducted in a single tertiary university-affiliated hospital (2020-2023). On 01 July, 2021, we extended the conservative management duration of our term PROM protocol, such as to administer oxytocin after 24 rather than 12 h.  We compared the rate of chorioamnionitis between the two induction protocols, among women at term with PROM and without evidence of active labor at admission. Exclusion criteria were complications requiring prompt delivery, and multiple pregnancies.

Results: Following the protocol of 24-h (n=962) versus 12-h (n=802) induction, the proportions were higher of women who labored spontaneously (50.4% vs 41.5%, p< 0.001), and who had chorioamnionitis (7.5% vs 4.7%, p=0.017); cesarean deliveries (CD) occurred similarly. Following the 24-h versus 12-h induction protocol, the rates were higher of neonatal intensive care unit admission (6.2% vs 3.6%, p=0.012), antibiotic administration (5.7% vs 2.9%, p=0.003), and respiratory distress (4.2% vs 1.0%, p=0.002) (Figure). Among women with a previous vaginal delivery, the rate of inductions was lower following the 24-h than 12-h protocol (46.5% vs 57.3%, p=0.041); maternal and neonatal outcomes were similar. Among women with a previous CD, the rates were lower following the 24-h vs. 12-h protocol, for oxytocin use (20.3% vs 43.2%, p=0.003) and CD (28.9% vs 48.6%, p=0.016).

Conclusion: Our results advocate shared decision-making in the management of term PROM. Women should be informed of the lower chance for induction and the higher risk of chorioamnionitis, with a 24-h induction protocol approach. Parous women and those with previous CD might benefit from longer expectant management.