[Term Prelabor Rupture of Membranes: CNGOF Guidelines for Clinical Practice - Definition, Epidemiology, Complications and Risk Factors]

Abstract

Objective: To synthesize current knowledge on definition, frequency, morbidity and risk factors related to term prelabor rupture of membranes.

Methods: The MedLine database, the Cochrane Library and French and foreign guidelines from 1980 to 2019 have been consulted.

Results: Term rupture of membranes is defined by the rupture of the membranes after 37 weeks of gestation (WG). Term prelabor rupture of membranes is defined by the rupture of membranes prior to the onset of labor after 37 WG. According to unpublished data from the 2016 French National Perinatal Survey, 26,5% of women with singleton pregnancies had a term rupture of membranes before their admission into labor ward. We were not able to assess if those were "prelabor" or not (LE3). Among women admitted with term rupture of membranes, 35,6% were still not in labor 12hours after the rupture i.e. 8,9% of all singleton pregnancies (LE3). Reported rates of term prelabor rupture of membranes vary between 6 and 22% in singleton pregnancies (LE3). Term prelabor rupture of membranes is associated with a risk of fever before (LE3), during (LE3) and after labor (LE3), as well as intrauterine and neonatal infection (LE3). The frequency of these complications in the context of a routine antibiotic prophylaxis is unknown. The expert group chose a delay of 12hours without spontaneous labor to differentiate a physiological situation from a potentially risky situation that could justify a medical intervention (Professional consensus). Risk factors for term prelabor rupture of membranes include history of term prelabor rupture of membranes (LE3), nulliparity (LE3), uterine contractions requiring treatment (LE3) and first trimester bleeding (LE3).

Conclusion: Data on frequency, risk factors and morbidity of term prelabor rupture of membranes are limited or of poor quality.

Keywords: Facteurs de risque; Frequency; Fréquence; Morbidity; Morbidité; Mortality; Mortalité; Risk factors; Rupture des membranes à terme; Rupture des membranes à terme avant travail; Term prelabor rupture of membranes; Term rupture of membranes.