TOPLINE:

In women with prelabour rupture of membranes (PROM) at term, a latency period exceeding 12 hours was independently associated with a ninefold increase in the odds of maternal intrauterine infection, primarily chorioamnionitis and/or endometritis, despite active management with immediate induction of labour.

METHODOLOGY:

• Researchers conducted a retrospective cohort study to assess the risk for maternal intrauterine infection following PROM at term in a setting in which immediate induction of labour is advised and to identify its associated risk factors.
• They included 759 pregnant women with singleton pregnancies at term (37 + 0 to 41 + 6 weeks of gestation) complicated by PROM from a Portuguese tertiary care centre who delivered between 2020 and 2023.
• Participants were divided into two groups on the basis of the latency period from PROM to birth: 12 hours or less (n = 235) and more than 12 hours (n = 524). Latency was defined as the duration (in hours) from PROM to delivery; the mean maternal age for both the groups was around 31 years.
• PROM was diagnosed on the basis of clinical examination demonstrating the leakage of amniotic fluid.
• The primary outcome was maternal intrauterine infection, defined as clinical chorioamnionitis and/or endometritis.

TAKEAWAY:

• Overall, term PROM accounted for 9.7% of singleton pregnancies, with a mean latency time from PROM to birth of 21.3 hours.
• Clinical chorioamnionitis and/or endometritis were reported in 5.3% of women, with significantly higher rates seen in those with a latency period of more than 12 hours than in those with a latency period of 12 hours or less (7.3% vs 0.9%; P < .001).
• After adjustment for confounders, women with a latency period longer than 12 hours had higher odds of chorioamnionitis and/or endometritis (odds ratio, 9.0; 95% CI, 2.1-39.2).
• No maternal deaths were reported. Neonatal outcomes were comparable between the two groups; one neonatal death was reported in each group.

IN PRACTICE:

"With the implementation of immediate IOL [induction of labour] after term PROM, a latency period longer than 12 hours remains associated with an increased risk of maternal infection, stressing the need to evaluate other prophylactic measures, and eventually antibiotic prophylaxis for this subgroup of women," the authors wrote.

SOURCE:

This study was led by Inês Martins, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal. It was published online on April 18, 2026, in the International Journal of Gynecology & Obstetrics.

LIMITATIONS:

This study was retrospective in nature and relied on a computerised database. Data on the number and timing of vaginal examinations, Bishop score at admission, and exact duration of induction of labour were not available. The study was conducted at a single tertiary care centre, limiting the generalisability to other settings.

DISCLOSURES:

This study did not receive any funding. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.