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

Faculty have requested this content not be shared on social media

CME Credit Offered

Poster Icons

Foundation Awardee

No Social Media

Back

Q&A

Clinical Obstetrics

Poster Session 1

(158) Nulliparas with term PROM and an unfavorable cervix, induction of labor with prostaglandin or oxytocin

Tuesday, February 13, 2024

10:30 AM – 12:00 PM

Location: Prince George's Exhibit Hall CDE, Lower Atrium Level

Primary Author(s)

Maayan Bas Lando, MD

Shaare Zedek Medical Center, Hebrew University of Jerusalem
Jerusalem, Yerushalayim, Israel

Presenting Author(s)

Majida Ewida, MD (she/her/hers)

Shaare Zedek Medical Center, Faculty of Medicine, Hebrew University of Jerusalem
Jerusalem, Yerushalayim, Israel

Coauthor(s)

SH

Sarit Helman, MD

Shaare Zedek Medical Center, Hebrew University of Jerusalem
Jerusalem, Yerushalayim, Israel
SG

Sorina Grisaru-Granovsky, MD, PhD

Shaare Zedek Medical Center, Hebrew University of Jerusalem
Jerusalem, Yerushalayim, Israel
OR

Orna Reichman, MD, MPH

MD
Shaare Zedek Medical Center, affiliated with the Hebrew University Medical School of Jerusalem
Jerusalem, Israel, Israel

Objective: To study whether the time from induction of labor (IOL) to delivery differs between nulliparas with premature rupture of membrane (PROM) and an unfavorable cervix induced by prostaglandins (PGE2) versus oxytocin.

Study Design: A retrospective matched cases study. Data were extracted from a validated real-time computerized data base. All nulliparas with term PROM who underwent induction between January 2006 to April 2023 were identified. Cases induced by either PGE2 or oxytocin were matched on the following criteria (1) time from PROM to IOL, (2) modified Bishop score defined by cervix dilatation and effacement prior to induction, (3) newborn birthweight, and (4) vertex position Statistics: Descriptive, means±SDs, medians+IQR. Comparisons: chi-square, independent samples T-test and Kaplan Mayer survival curve.

Results: Ninety-five matched cases were identified. Maternal age (26±4.7 years old, p=0.203) and gestational age at delivery (38.6±0.6, p=0.701) were similar between the groups. Matched factors including modified Bishop score (2.0 versus 2.3, p=0.187), time from PROM to IOL (23.5 ± 19.2 versus 24.3 ± 21.4 p=0.780), birth weight of newborn (3111g versus 3101g, p=0.842) and occiput anterior position (present on 98% in both groups p=0.687) were also comparable . Time from IOL to delivery was significantly shorter by 3 hours and 36 minutes in the group induced by oxytocin compared to PGE2, (p=0.029). The Kaplan-Meier survival curve demonstrated a significant difference between time from IOL to delivery. Within 24 hours, 55(58%) of those induced with PGE2 delivered compared to 72(76%) of those induced by oxytocin, (p=0.033), see figure. Cesarean delivery rate [17(18%) versus 18(19%)], blood transfusion rates [3(3%) versus 2(2%)], and Apgar scores (8.9 versus 8.8) were similar between the groups, p</span>≥0.387.

Conclusion: Among nulliparas with term PROM and an unfavorable cervix, induction with oxytocin results in a shorter time from IOL to delivery and a higher rate of vaginal delivery within 24 hours, with no elevated risk for cesarean delivery.