Chorioamnionitis after premature rupture of membranes in nulliparas undergoing labor induction: prostaglandin E2 vs. oxytocin
Author:
Gulersen Moti12ORCID, Zottola Cristina2, Li Xueying3, Krantz David3, DiSturco Mariella2, Bornstein Eran2ORCID
Affiliation:
1. Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology , North Shore University Hospital – Zucker School of Medicine at Hofstra/Northwell , Manhasset , NY , USA 2. Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology , Lenox Hill Hospital – Zucker School of Medicine at Hofstra/Northwell , New York , NY , USA 3. Eurofins NTD , Melville , NY , USA
Abstract
Abstract
Objectives
To assess the risk of chorioamnionitis in nulliparous, term, singleton, vertex (NTSV) pregnancies with premature rupture of membranes (PROM) and an unfavorable cervix undergoing labor induction with either prostaglandin E2 (PGE2) or oxytocin only.
Methods
Retrospective cohort of NTSV pregnancies presenting with PROM who underwent labor induction with either PGE2 (n=94) or oxytocin (n=181) between October 2015 and March 2019. The primary outcome of chorioamnionitis was compared between the two groups. 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 (aHR).
Results
Baseline characteristics were similar between the two groups. Cervical ripening with PGE2 was associated with an increased rate of chorioamnionitis (18.1 vs. 6.1%; aOR 4.14, p=0.001), increased neonatal intensive care unit admissions (20.2 vs. 9.9%; aOR 2.4, p=0.02), longer time interval from PROM to delivery (24.4 vs. 17.9 h; aHR 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.
Conclusions
Based on our data, the use of oxytocin appears both superior and safer compared to PGE2 in NTSV pregnancies with PROM undergoing labor induction.
Publisher
Walter de Gruyter GmbH
Subject
Obstetrics and Gynaecology,Pediatrics, Perinatology, and Child Health
Reference21 articles.
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