title: Premature rupture of membranes at term in low risk women: how long should we wait in the "latent phase"?
abstract: OBJECTIVE
  How long the waiting time may be for the onset of spontaneous labor after prelabor rupture of fetal membranes at term (tPROM) remains controversial.
  
  
  METHODS
  The study is an observational cohort study of 6032 women. All obstetric patients with no obstetric risk factors, other than tPROM, were included. The analysis focused on the onset of labor (spontaneous vs. induction), maternal morbidity [cesarean section (CS) and chorioamnionitis] and neonatal morbidity (suspected infection) related to a policy of waiting for the onset of spontaneous labor within 48 h of tPROM.
  
  
  RESULTS
  tPROM was experienced by 1439 women. A careful clinical management shows a very low rate of clinical chorioamnionitis (2.3%) and neonatal infection rate (2.8%), even after 24 h from tPROM. The overall incidence of CS was 4.5%. Furthermore, a policy of waiting for the onset of spontaneous labor within 48 h of tPROM is associated with a low rate of CS, less than induced labor (OR=1.76; 95% confidence interval 1.03-3.02; P<0.004).
  
  
  CONCLUSIONS
  Fetal and/or maternal morbidity in tPROM women may not increase if there is a strict analysis of maternal and or fetal risk factors added to a careful clinical management. Moreover, it may be useful to wait for spontaneous labor in order to enhance the patient's chance of vaginal delivery.
authors.forename: Armando
authors.initials: A
authors.lastname: Pintucci
authors.forename: Virginio
authors.initials: V
authors.lastname: Meregalli
authors.forename: Paolo
authors.initials: P
authors.lastname: Colombo
authors.forename: Angelo
authors.initials: A
authors.lastname: Fiorilli
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data*; D002821:Chorioamnionitis / Q000453:epidemiology*; D015331:Cohort Studies; D005260:Female; D005322:Premature Rupture of Fetal Membranes; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology; D007558:Italy / Q000453:epidemiology; D007751:Labor, Induced / Q000009:adverse effects / Q000706:statistics & numerical data*; D011247:Pregnancy; D012307:Risk Factors; D057832:Watchful Waiting