الفهرس 
Introduction and rationaleOnly 14 pages are availabe for public view
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Abstract
The aim of this study was to predict caesarean delivery rates after spontaneous rupture of membranes during the latent phase of labor.This study Included 324 women presented to the Obstetrics Emergency Department in labor. They were divided into two equal groups, each containing 162 women. The early rupture of membrane (ROM) group (the study group) included those women who had their membranes ruptured spontaneously during the latent phase of labor; and the late ROM group (the control group) included women presented with intact membranes who had spontaneous or induced rupture of membranes during the active phase of labor (i.e., at cervical dilatation 4 cm).
Women in both groups were subjected to detailed history and examination as well as assessment of fetal wellbeing. Labor characteristics were recorded in partograms and assessed to identify women in need for cervical ripening with misoprostol or labor augmentation with oxytocin.
Misoprostol was not used in women in the control group who had a normal course of labor. All newborns were resuscitated and assessed for birth weight, Apgar score, meconium staining and need for NICU admission.
The principal finding in this study was that patients with early ROM had a fourfold higher rate of CS than those with late ROM (11.7% vs. 3.1%; P value = 0.003). The major indications for CS were fetal distress (52%) and failure to progress (40%).
The admission to delivery time was significantly longer in the early ROM although the mean cervical dilatation on admission was higher in the early ROM group than in the late ROM group. Thus, labor was more prolonged in the study groupLogistic regression analysis revealed that early rupture of membranes is a significant risk factor inducing a 3.5-fold higher risk for caesarean delivery. Other important independent risk factors associated with increased caesarean delivery in our study were suspicious and pathological CTG, low parity, and low Bishop Score.