Related Experiment Video
Updated: May 23, 2026
04:18
Modeling Ascending Vaginal Infection, Preterm Birth, and Neonatal Morbidity in Mice
Published on: October 10, 2025
Artificial versus Spontaneous Rupture of Membranes after Balloon Ripening: Implications for Maternal Infectious
Raneen Abu Shqara1,2, Nadir Ganem3,4, Ala Aiob3,4
1Department of Obstetrics and Gynecology, Galilee Medical Center, Nahariya, Israel, rabushqara@gmail.com.
Gynecologic and Obstetric Investigation
|May 21, 2026
Summary
Artificial rupture of membranes (AROM) after balloon catheter ripening increased maternal infection and cesarean delivery rates. Spontaneous rupture of membranes (SRM) was associated with lower risks. Further research is needed for definitive conclusions.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Infectious Disease Epidemiology
Background:
- Artificial rupture of membranes (amniotomy) is often used to shorten labor during induction.
- Evidence on infectious consequences of amniotomy after mechanical cervical ripening is limited.
- This study investigates maternal infectious morbidity following artificial versus spontaneous rupture of membranes (ROM) after balloon catheter ripening and oxytocin augmentation.
Purpose of the Study:
- To compare maternal infectious morbidity between artificial ROM (amniotomy) and spontaneous ROM (SRM).
- To assess the association between mode of ROM and outcomes like clinical chorioamnionitis, intrapartum fever, and cesarean delivery rates.
- To evaluate neonatal complications in relation to the mode of ROM.
Main Methods:
- Retrospective cohort study of 1,115 term singleton pregnancies induced with a balloon catheter and oxytocin.
- Participants categorized into artificial ROM (amniotomy) or spontaneous ROM groups.
- Clinical, obstetric, microbiological, and neonatal data analyzed; Firth penalized logistic regression used for adjusted analyses.
Main Results:
- Amniotomy (65% of cases) was linked to significantly higher rates of clinical chorioamnionitis (3.0% vs. 0.3%), intrapartum fever (7.4% vs. 1.5%), and positive chorioamniotic cultures (11.3% vs. 6.2%).
- Despite a shorter ROM-to-delivery interval, amniotomy was associated with higher cesarean delivery rates (13.5% vs. 3.3%), including for non-reassuring fetal heart rate.
- Adjusted analyses confirmed amniotomy's independent association with increased clinical chorioamnionitis, intrapartum fever, and cesarean delivery.
Conclusions:
- Artificial ROM following balloon catheter ripening is associated with increased maternal infectious morbidity and cesarean delivery rates.
- The retrospective design limits causal inference, and potential confounding factors exist.
- Findings suggest a selective approach to ROM management and highlight the need for prospective studies.
Related Concept Videos
01:28Development of the Oral Microbiota
The establishment of the oral microbiome begins before birth, challenging the long-held belief that the fetal oral cavity is sterile. The presence of oral microbes such as Streptococcus and Fusobacterium in amniotic fluid suggests that microbial exposure may occur in utero, potentially through translocation from the maternal oral or gastrointestinal tract. This early colonization primes the neonatal immune system and sets the stage for subsequent microbial succession. Maternal health,...
01:30Development of Human Microbiota
The human microbiota begins developing at birth and undergoes continual change as we age. Infancy marks a critical period of microbial sensitivity, offering a “window of opportunity” during which beneficial microbes help mature the immune system. By age three, children typically develop a more stable and diverse microbial community. Newborns acquire microbes from their immediate environment; vaginal delivery favors maternal vaginal microbes, while cesarean births favor microbes from the skin...