Predictors of cesarean delivery after prelabor rupture of membranes at term.
OBJECTIVE
To identify the significant predictors of cesarean delivery after prelabor rupture of membranes (PROM) at term.


METHODS
In a multicenter study involving 72 institutions in six countries, 5041 women were randomized to induction of labor with oxytocin or prostaglandins or to expectant management. We did univariate and multivariate logistic regression analyses to determine the statistically significant independent predictors of cesarean delivery (P < .05).


RESULTS
The following variables were found to be significantly associated with cesarean delivery: delivery in Israel, versus Canada (odds ratio [OR] 0.34); delivery in Australia, versus Canada (OR 1.93); nulliparity (OR 2.81); labor lasting more than 12 hours, versus less than 6 hours (OR 2.78); labor lasting 6-12 hours, versus less than 6 hours (OR 1.66); previous cesarean delivery (OR 2.75); epidural anesthesia (OR 2.66); clinical chorioamnionitis (OR 2.42); internal fetal heart rate monitoring (OR 2.19); birth weight of at least 4000 g (OR 2.07); use of oxytocin (OR 1.97); maternal age of at least 35 years (OR 1.44); latent period of at least 12 hours (OR 1.41); and meconium staining (OR 1.41).


CONCLUSIONS
Strong predictors of cesarean delivery after PROM at term were country of birth, nulliparity, long labor, previous cesarean delivery, and epidural anesthesia.
Peleg
D
D
Department of Obstetrics and Gynecology, Poriya Hospital, Tiberias, Israel. mary.hannah@utoronto.ca
Hannah
M E
ME
Hodnett
E D
ED
Foster
G A
GA
Willan
A R
AR
Farine
D
D
D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007745:Labor Onset; D007751:Labor, Induced; D010121:Oxytocin / Q000627:therapeutic use*; D011247:Pregnancy; D012044:Regression Analysis; D013997:Time Factors
D010121:Oxytocin