title: Predictors for prolonged interval from premature rupture of membranes to spontaneous onset of labor at term.
abstract: OBJECTIVE
  To identify predictors for prolonged interval from premature rupture of membranes (PROM) to spontaneous onset of labor in women presenting with PROM and low Bishop score at term.
  
  
  METHODS
  A retrospective study of women presenting with PROM and Bishop score < 7 at term (≥37weeks) in a tertiary hospital (2013-14). Spontaneous onset of labor was defined as presence of regular uterine contractions and Bishop score ≥ 7. Women with interval from PROM to spontaneous onset of labor of <24hours (short interval group) were compared to those with interval ≥ 24 hours (prolonged interval group). Women who underwent induction of labor at < 24 hours from PROM were excluded.
  
  
  RESULTS
  Among 625 women who met inclusion criteria, 155 (24.8%) had a prolonged interval to onset of labor. In multivariate analysis, prolonged PROM was associated with (OR, 95%CI) cervical dilatation (0.35, 0.24-0.52, p < 0.001), effacement (0.97, 0.96-0.99, p < 0.001) and uterine contraction (0.51, 0.32-0.80, p = 0.004). A multivariable prediction model including maternal age, parity, cervical dilatation and effacement, gestational age and neonatal birthweight was associated with an AUC of receiver-operator characteristic curve of 0.739 (0.631-0.847, p < 0.001) for predicting prolonged PROM.
  
  
  CONCLUSIONS
  Uterine contractions and cervical examination parameters can be used for prediction of prolonged interval to spontaneous onset of labor in women with term PROM.
authors.affiliation: a Rabin Medical Center, Helen Schneider Hospital for Women , Petach Tikva , Israel and.|b Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel.
authors.forename: Liran
authors.initials: L
authors.lastname: Hiersch
authors.affiliation: a Rabin Medical Center, Helen Schneider Hospital for Women , Petach Tikva , Israel and.|b Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel.
authors.forename: Eyal
authors.initials: E
authors.lastname: Krispin
authors.affiliation: a Rabin Medical Center, Helen Schneider Hospital for Women , Petach Tikva , Israel and.|b Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel.
authors.forename: Amir
authors.initials: A
authors.lastname: Aviram
authors.affiliation: b Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel.
authors.forename: Moran
authors.initials: M
authors.lastname: Mor-Shacham
authors.affiliation: a Rabin Medical Center, Helen Schneider Hospital for Women , Petach Tikva , Israel and.|b Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel.
authors.forename: Rinat
authors.initials: R
authors.lastname: Gabbay-Benziv
authors.affiliation: b Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel.
authors.forename: Yariv
authors.initials: Y
authors.lastname: Yogev
authors.affiliation: b Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel.
authors.forename: Eran
authors.initials: E
authors.lastname: Ashwal
mesh_terms: D000328:Adult; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000503:physiopathology*; D006801:Humans; D007745:Labor Onset / Q000502:physiology*; D016015:Logistic Models; D010298:Parity; D011237:Predictive Value of Tests; D011247:Pregnancy; D012372:ROC Curve; D012189:Retrospective Studies; D013997:Time Factors; D014590:Uterine Contraction / Q000502:physiology
keywords: Bishop score; latency; outcome; predictors; premature rupture of membranes