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Published on: January 12, 2018
Determination of the Practical Latent Phase for Term and Low-Risk Women with Premature Rupture of Membrane
Somayeh Khanjani1, Leila Mousavi1, Fatemeh Abbasi1
1Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Background:
To compare the outcomes of 12-hour versus 24-hour latent phase durations in low-risk women with premature rupture of membranes (PROM).
Materials And Methods:
This prospective study included 213 women with PROM at ≥37 weeks of gestation, randomized into two groups: 12-hour (n = 142) and 24-hour (n = 71) latent phase management. Participants underwent cervical ripening followed by oxytocin induction. Primary outcomes included cesarean section rates and maternal and neonatal complications.
Results:
The 24-hour latent phase group showed a clinically relevant but non-significant 32% reduction in cesarean section rates compared to the 12-hour group (OR: 1.32, 95% CI: 0.73-2.38, P = 0.360). No statistically significant differences were observed in maternal complications (emergency cesarean section, atony, chorioamnionitis) or neonatal outcomes (NICU admission, Apgar scores <7) between groups (all P values > 0.05). Nulliparous women had numerically higher but statistically nonsignificant complication rates than multiparous women (all P values > 0.05).
Conclusion:
Extending the latent phase to 24 hours in carefully selected PROM cases may offer a clinically meaningful reduction in cesarean sections, though this finding was not statistically significant. The approach did not increase maternal or neonatal risks. Parity-specific trends warrant further investigation.
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