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[Premature rupture of membranes≥37 weeks of gestation: Predictive factors for labour onset within 24hours]
C Huret1, B Pereira2, V Collange1
1Pôle femme et enfant, CHU Estaing, CHU de Clermont-Ferrand, 1, place Lucie-et-Raymond-Aubrac, 63003 Clermont-Ferrand cedex 1, France.
Objectives:
To identify predictive criteria for a positive expectation in the context of rupture of membranes after 37 WG.
Methods:
Single-center retrospective study including ROM≥37 WG. The primary outcome was labour onset within 24hours. We compared predictive factors for occurrence of spontaneous labour and described obstetrical and neonatal outcomes according to initial Bishop score<6 or ≥6.
Results:
From January 2013 to December 2014, 520 patients were included. The predictive factors in case of unfavorable cervix were clinical leakage (P<0.001) and a cervical dilatation≥2cm (P<0.001) according to multivariate analysis. When the expectancy failed, there was a higher rate of cesarean section (24.3% vs. 9.6% P<0.001) but no more proven maternal-fetal infection. In case of Bishop≥6, we identified no predictive factor for labour onset but Apgar<7 at 5minutes (18.7% vs. 3.2% P=0.01) and admission to neonatal unit (18.8% vs. 3.2% P=0.04) were more frequent without majoration of maternal-fetal infection.
Conclusion:
The favorable expectation was the outcome for 70.8% of ROM at term. Clinical leakage and dilated cervix appeared as the main predictors in case of Bishop<6. Majoration of low Apgar score and admission to neonatal unit could be increased when no labour onset occurred despite Bishop≥6.
