Comparative study of induction of labor in nulliparous women with premature rupture of membranes at term compared to those with intact membranes: duration of labor and mode of delivery.
OBJECTIVE
To evaluate the effect of premature rupture of membranes (PROM) at term on the duration of labor and mode of delivery in comparison with intact membranes in nulliparous women with an unfavorable cervix whose labor was induced.


METHODS
This retrospective cohort study included all term nulliparous women with an unfavorable cervix requiring labor induction over a 2-year period. Prostaglandin E(2) (dinoprostone) and oxytocin were used for labor induction. Criteria for enrolment included (i) singleton pregnancy; (ii) term nulliparous women; or (iii) Bishop score below 6. Statistics were analyzed with Student's t-test, chi(2)-test, Fisher's exact test, and multiple logistic regression.


RESULTS
Our study subjects were 82 women whose labor was induced for PROM and 219 women with intact membranes whose labor was induced for social or fetal reasons. The mean durations of active phase of labor were not significantly different between women with PROM and those with intact membranes. However, the women with PROM had a significantly longer mean duration of second stage and a higher rate of cesarean delivery for failure to progress than those with intact membranes. Multiple logistic regression demonstrated that only PROM and fetal macrosomia were significantly associated with an increased risk of cesarean delivery for failure to progress after other confounding variables were adjusted.


CONCLUSIONS
Labor induction for PROM at term in nulliparous women with an unfavorable cervix is associated with longer duration of the second stage and a higher risk of cesarean delivery for failure to progress in comparison to those with intact membranes.
Park
Kyo Hoon
KH
Department of Obstetrics, College of Medicine, Seoul National University, Seoul, Korea. pkh0419@snubh.org
Hong
Joon-Seok
JS
Ko
Ji Kyung
JK
Cho
Yong Kyoon
YK
Lee
Chul Min
CM
Choi
Hoon
H
Kim
Bok Rin
BR
D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data; D036861:Delivery, Obstetric / Q000379:methods*; D005260:Female; D005320:Fetal Macrosomia; D005322:Premature Rupture of Fetal Membranes / Q000628:therapy*; D006801:Humans; D007751:Labor, Induced; D007743:Labor, Obstetric / Q000502:physiology*; D016015:Logistic Models; D010298:Parity; D011247:Pregnancy; D012189:Retrospective Studies; D013997:Time Factors