TITLE:
Is Induction of Labor with Early Rupture of Membranes Associated with an Increased Rate of Clinical Chorioamnionitis?
AUTHORS:
Laura Rankin, Matthew Romagano, Shauna Williams, Joseph Apuzzio
KEYWORDS:
Amniotomy, Cesarean Delivery, Chorioamnionitis, Induction of Labor, Intraamniotic Infection, Perinatal Infection, Rupture of Membranes, Term Pregnancy
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.14 No.2,
February
23,
2024
ABSTRACT: Objective: The objective of this study was to determine if early rupture of
membranes (ROM) in women undergoing induction of labor (IOL) at term is
associated with an increased rate of clinical chorioamnionitis. Study Design: A
retrospective cohort study was performed on women undergoing IOL. Early ROM was
defined as ROM at a modified Bishop score less than 5, cervical dilation less
than 4 cm, or cervical effacement less than 80%. The rate of clinical
chorioamnionitis was compared between women with early and late ROM. Results: The rate of clinical
chorioamnionitis was 8.6% (24/279). ROM at an effacement of less than 80% was
associated with a rate of clinical chorioamnionitis of 15.4% (12/78) compared
to 6.0% (12/201) at an effacement of equal to or greater than 80%, p = 0.017.
The rate of cesarean delivery was higher for
patients with early ROM by any definition: 32% compared to 17.5% by
modified Bishop score (p = 0.031), 32.4% versus 18.2% by cervical dilation (p =
0.049), and 33.3% versus 14.9% by cervical effacement (p = 0.001). Conclusions: In
patients undergoing IOL, early ROM may be associated with an increased rate of
clinical chorioamnionitis when performed at a cervical effacement of less than
80% and an increased rate of cesarean delivery.