Premature rupture of membranes ≥ 37 weeks of gestation: Predictive factors for labour onset within 24 hours

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 24 hours. 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 >= 2 cm (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 5 minutes (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. (C) 2017 Elsevier Masson SAS. All rights reserved.