title: Premature rupture of the membranes at term: time to reevaluate the management.
abstract: To compare maternal and neonatal outcomes in induced vs. expectant management of term PROM.
  
  
  
  This retrospective study included patients with term PROM. A total of 325 were enrolled: 213 managed expectantly and 112 induced at admission and matched according to gestational age. Expectant management group patients were allowed to defer labour induction up to 48 h. Primary outcome measures were maternal or foetal signs of infection (chorioamnionitis, early neonatal sepsis or postpartum endometritis) and prolonged maternal hospitalization. Secondary outcome was caesarean delivery rate.
  
  
  
  All group characteristics were comparable except that expectant management included more nulliparous women. Women managed expectantly had a higher rate of prolonged hospitalization [15 (7 %) vs. 2 (1.8 %); P = 0.043] as an indication of maternal complications, compared to induction management. They also had a higher rate of caesarean delivery [34 (16.4 %) vs. 8 (7.1 %), respectively; P = 0.024]. Adjustment for parity did not change the results. Early neonatal outcomes were similar between groups.
  
  
  
  Expectant management increases the likelihood of caesarean delivery and prolonged maternal hospitalization. This should be considered when advising patients with term PROM regarding labour induction.
authors: Department of Obstetrics and Gynecology, Meir Medical Center, 59 Tschernichovsky, 44282, Kfar Saba, Israel. sadeh.dana@gmail.com.|Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. sadeh.dana@gmail.com.
authors: Dana
authors: 0000-0002-6343-3538
authors: D
authors: Sadeh-Mestechkin
authors: Department of Obstetrics and Gynecology, Meir Medical Center, 59 Tschernichovsky, 44282, Kfar Saba, Israel.|Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors: Nivin
authors: N
authors: Samara
authors: Department of Obstetrics and Gynecology, Meir Medical Center, 59 Tschernichovsky, 44282, Kfar Saba, Israel.|Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors: Amir
authors: A
authors: Wiser
authors: Department of Obstetrics and Gynecology, Meir Medical Center, 59 Tschernichovsky, 44282, Kfar Saba, Israel.|Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors: Ofer
authors: O
authors: Markovitch
authors: Department of Obstetrics and Gynecology, Meir Medical Center, 59 Tschernichovsky, 44282, Kfar Saba, Israel.|Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors: Gil
authors: G
authors: Shechter-Maor
authors: Department of Obstetrics and Gynecology, Meir Medical Center, 59 Tschernichovsky, 44282, Kfar Saba, Israel.|Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors: Tal
authors: T
authors: Biron-Shental
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000379:methods*; D015331:Cohort Studies; D005260:Female; D005322:Premature Rupture of Fetal Membranes; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D047928:Premature Birth; D012189:Retrospective Studies; D047929:Term Birth
keywords: Caesarean delivery; Chorioamnionitis; Premature rupture of membranes (PROM); Term delivery