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• W3126486702 abstract "We set out to determine whether cervical ripening with prostaglandin E2 (PGE2) is associated with an increased risk of intraamniotic infection (IAI) in nulliparous women undergoing labor induction with prelabor rupture of membranes (PROM) and an unfavorable cervix. Retrospective cohort study of singleton, term, nulliparas presenting with PROM from October 2015 to March 2019. Women undergoing induction with PGE2 or oxytocin and a Bishop score (BS) of ≤ 6 were eligible for inclusion. Patients with painful contractions, documented cervical change, BS > 6, cervical dilation ≥ 3cm, PROM > 18 hours and missing data were excluded. The primary outcome of IAI was compared between women induced with PGE2 and those induced with oxytocin only. Secondary outcomes included time interval from PROM to delivery, mode of delivery, as well as several maternal and neonatal outcomes. Statistical analysis included Chi-squared and Wilcoxon rank-sum tests, as well as logistic regression. For time to delivery, a Cox proportional hazard regression was used to determine the hazard ratio (HR) and adjusted HR. 275 patients comprised the study cohort. Of those, 94 (34.2%) underwent cervical ripening with PGE2 and 181 (65.8%) underwent induction with oxytocin. Baseline characteristics were similar between the two groups (Table 1). Cervical ripening with PGE2 was associated with an increased rate of IAI (18.1% vs. 6.1%; aOR 4.14, P = 0.001), more NICU admissions (20.2% vs. 9.9%; aOR 2.4, P = 0.02), longer time interval from PROM to delivery (24.4 hrs vs. 17.9 hrs; aOR 0.56, P = < 0.0001), and lower incidence of meconium (7.4% vs. 14.4%; aOR 0.26 P = 0.01), compared to the oxytocin group (Table 2). Our data show an approximately 3-fold increase in rate of IAI and 2-fold increase in rate of NICU admission associated with PGE2 use for cervical ripening in nulliparous women with PROM, while the time interval from PROM to delivery is longer. Thus, the use of oxytocin alone appears both superior and safer compared to PGE2 in this select patient population.View Large Image Figure ViewerDownload Hi-res image Download (PPT)" @default.
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• W3126486702 date "2021-02-01" @default.
• W3126486702 modified "2023-10-05" @default.
• W3126486702 title "313 Adverse outcomes associated with prostaglandin E2 ripening in nulliparous women with prelabor rupture of membranes" @default.
• W3126486702 doi "https://doi.org/10.1016/j.ajog.2020.12.335" @default.
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