Determination of the Practical Latent Phase for Term and Low-Risk Women with Premature Rupture of Membrane

Abstract

Background: To compare the outcomes of 12-hour versus 24-hour latent phase durations in low-risk women with premature rupture of membranes (PROM). Materials and Methods: This prospective study included 213 women with PROM at >= 37 weeks of gestation, randomized into two groups: 12-hour (n = 142) and 24-hour (n = 71) latent phase management. Participants underwent cervical ripening followed by oxytocin induction. Primary outcomes included cesarean section rates and maternal and neonatal complications. Results: The 24-hour latent phase group showed a clinically relevant but non-significant 32 reduction in cesarean section rates compared to the 12-hour group (OR: 1.32, 95 CI: 0.73-2.38, P = 0.360). No statistically significant differences were observed in maternal complications (emergency cesarean section, atony, chorioamnionitis) or neonatal outcomes (NICU admission, Apgar scores <7) between groups (all P values > 0.05). Nulliparous women had numerically higher but statistically nonsignificant complication rates than multiparous women (all P values > 0.05). Conclusion: Extending the latent phase to 24 hours in carefully selected PROM cases may offer a clinically meaningful reduction in cesarean sections, though this finding was not statistically significant. The approach did not increase maternal or neonatal risks. Parity-specific trends warrant further investigation.