Predictors of Vaginal Delivery Following Stimulation of Uterine Contractions for Term Premature Rupture of Membranes

Context: Premature rupture of membranes (PROM) is a significant event as it may lead to maternal complications, increased operative procedure, neonatal morbidity, and mortality. Aim: To determine the predictors of successful vaginal delivery in pregnant women undergoing stimulation of uterine contractions following premature rupture of membranes (PROM). Settings and Design: This prospective cohort study was conducted at the University of Benin Teaching Hospital, Benin City, Nigeria. Materials and Methods: Seventy-four pregnant women between the gestational ages of 37 weeks and 41 weeks with a live singleton fetus in cephalic presentation and no contraindication to vaginal delivery who had stimulation of uterine contractions following term PROM were included in this study. The main outcome measure was the route of delivery. Statistical Analysis: The analysis was done with IBM statistical package for social science (SPSS) Statistics v21, and a P value <= 0.05 was considered statistically significant. Results: Sixty-two (83.8%) women had a vaginal delivery. The mean age and gestational age were 29.76 +/- 3.69 years and 39.04 +/- 1.15 weeks, respectively. The chance of vaginal delivery was increased with BMI <30 (RR = 9.091, 95% CI = 1.827-45.246). The duration between rupture of membranes and commencement of stimulation of uterine contractions was <= 8 h (RR = 4.889, 95% CI = 1.307-18.293) also increasing the chance of achieving vaginal delivery. The time interval to 4 cm cervical dilatation <= 4 h (RR = 4.167, 95% CI = 1.141-15.215) and time interval to delivery <= 8 h (RR = 12.222, 95% CI = 2.433-61.402) also favored vaginal delivery. Conclusion: When uterine contractions are stimulated for PROM at term, vaginal delivery is predicted by maternal BMI <30, duration of rupture of membrane <= 8 h, and time interval to 4 cm cervical dilatation <= 4 h. Also, it was found was that vaginal delivery becomes less likely when the time interval from stimulation to delivery exceeds 8 h.