The Influence Of Induction Time For Premature Rupture Of Membranes In Term Pregnancy On Pregnancy Outcomes

Objective:To investigate the influence of induction time for premature rupture of membranes(PROM)in full-term pregnancy on pregnancy outcomes.Methods:1474 cases(PROM in full-term pregnancy)from January 2015 to December 2017 in Qingdao University Affiliated Hospital and Linyi Central Hospital were divided into four groups according to Bishop score and start time of inducing.Group A,Bishop score ≥6 points.Patients were induced by oxytoein who had ruptured over 2 hours and still not in labor;Group B,Bishop score ≥ 6 points.Patients were induced by oxytoein who had ruptured over 12 hours and still not in labor;Group C,Bishop score < 6 points.Patients were induced by oxytoein who had ruptured over 2 hours and still not in labor;Group D,Bishop score < 6points.Patients were induced by oxytoein who had ruptured over 12 hours and still not in labor.We retrospectively analyzed the pregnancy outcomes in four groups.Comparison of delivery rate,cesarean section rate,time from rupture of membranes to delivery,time of labor,puerperal infection rate,incidence of complication of induction of labor,intrauterine distress rate,neonatal transfer rate and other indicators.Results:(1)Comparison of delivery methods: The vaginal delivery rate of groups A,B,C,and D were 61.44%,63.40%,42.58%,and 51.92%,respectively.The vaginal delivery rate of group A was not significantly different from that of group B(P>0.05).The vaginal delivery rate in group D was higher than that in group C(P<0.05).The vaginal delivery rate in group A was higher than that in group C(P<0.05).The vaginal delivery rate in group B was higher than that in group D(P<0.05).(2)Comparison of maternal labor time: There was no significant difference in the first stage of labor,the second stage of labor,the third stage of labor and the total stage of labor between group A and group B,group C and group D,group A and group C,group B and group D(P>0.05).(3)Comparison of time from rupture of membrane to delivery: The time from rupture of membrane to delivery in group A was shorter than that in group B,the difference was statistically significant(P<0.05),and there was no significant difference in the time from the rupture of the membrane to delivery in group C compared with group D(P>0.05).The time from rupture of membrane to delivery in group A was shorter than that in group C,the difference was statistically significant(P<0.05);the time from rupture of membrane todelivery in group B was shorter than that in group D,the difference was statistically significant(P<0.05).(4)Comparison of complications of induction of labor: The puerperal infection rate in group A was significantly lower than that in group B(P<0.05).The puerperal infection rate of group C was not significantly different from that of group D(P>0.05).The puerperal infection rate was lower in group A than in group C(P<0.05).The puerperal infection rate of group B was not significantly different from that of group D(P>0.05).There was no significant difference in the postpartum hemorrhage rate,the incidence of umbilical cord prolapse,the incidence of oxytocin allergy,the incidence of amniotic fluid embolism,the incidence of placental abruption,and the incidence of aura uterus rupture between group A and group B,group C and group D,group A and group C,group B and group D(P>0.05).The incidence of complications of induce in group A was significantly lower than that in group B(P<0.05),and that in group C was higher than that in group D(P<0.05).The incidence of complications of induce in group A was significantly lower than that in group C(P<0.05),and there was no significant difference between group B and group D(P>0.05).(5)Comparison of neonatal complications:There was no significant difference in the fetal distress rate and the neonatal change department rate between the group A and group B(P>0.05).The fetal distress rate and the neonatal change department rate in group C were higher than in group D(P<0.05).The fetal distress rate and the neonatal change department rate in group C were higher than in group A(P<0.05).There was no significant difference in the fetal distress rate and the neonatal change department rate between the group B and group D(P>0.05).Conclusion:Patients with PROM could be induced labor when ruptured over 2 hours with cervical ripening;or be induced labor when ruptured over 12 hours for cervical immaturity.