Abstract
Objective: To identity the significant predictors of cesarean delivery after prelabor rupture of membranes (PROM) at term. Methods: In a multicenter study involving 72 institutions in six countries, 5041 women were randomized to induction of labor with oxytocin or prostaglandins or to expectant management. We did univariate and multivariate logistic regression analyses to determine the statistically significant independent predictors of cesarean delivery (P < .05). Results: The following variables were found to be significantly associated with cesarean delivery: delivery in Israel, versus Canada (odds ratio [OR] 0.34); delivery in Australia, versus Canada (OR 1.93); nulliparity (OR 2.81); labor lasting more than 12 hours, versus less than 6 hours (OR 2.78); labor lasting 6-12 hours, versus less than 6 hours (OR 1.66); previous cesarean delivery (OR 2.75); epidural anesthesia (OR 2.66); clinical chorioamnionitis (OR 2.42); internal fetal heart rate monitoring (OR 2.19); birth weight of at least 4000 g (OR 2.07); use of oxytocin (OR 1.97); maternal age of at least 35 years (OR 1.44); latent period of at least 12 hours (OR 1.41); and meconium staining (OR 1.41). Conclusion: Strong predictors of cesarean delivery after PROM at term were country of birth, nulliparity, long labor, previous cesarean delivery, and epidural anesthesia.
| Original language | English |
|---|---|
| Pages (from-to) | 1031-1035 |
| Number of pages | 5 |
| Journal | Obstetrics and Gynecology |
| Volume | 93 |
| Issue number | 6 |
| DOIs | |
| State | Published - Jun 1999 |
| Externally published | Yes |
Bibliographical note
Funding Information:Supported by Medical Research Council of Canada grant no. MA-11392.
Funding Information:
This study was a retrospective analysis of data, so there might be other fetal and maternal factors associated with cesarean delivery after PROM concerning which we had no or inadequate information. We had no information on environmental factors other than country of birth. Future prospective research should involve evaluation of changes in environment, while controlling for fetal and maternal factors. The ongoing Nursing SCIL Trial, funded by the National Institutes of Health, coordinated in Toronto by EDH, is an example of such an evaluation. The Nursing SCIL Trial is a multicenter, randomized controlled trial evaluating the effect of continuous, supportive care in labor by nurses in institutions in the United States and Canada.
Funding
Supported by Medical Research Council of Canada grant no. MA-11392. This study was a retrospective analysis of data, so there might be other fetal and maternal factors associated with cesarean delivery after PROM concerning which we had no or inadequate information. We had no information on environmental factors other than country of birth. Future prospective research should involve evaluation of changes in environment, while controlling for fetal and maternal factors. The ongoing Nursing SCIL Trial, funded by the National Institutes of Health, coordinated in Toronto by EDH, is an example of such an evaluation. The Nursing SCIL Trial is a multicenter, randomized controlled trial evaluating the effect of continuous, supportive care in labor by nurses in institutions in the United States and Canada.
| Funders | Funder number |
|---|---|
| National Institutes of Health | |
| Medical Research Council Canada | MA-11392 |