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Recording available 2/16-5/2
Recording available 2/16-5/2
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Poster Session 3

Category: Labor

Poster Session 3

(957) Time from Pre-labor Rupture of Membrane to Delivery in Grand Multipara Women at Term

Thursday, February 12, 2026
10:30 AM - 12:00 PM  

    Presenting Author(s)

  • Shai Ram, MD

    Ichilov Tel Aviv Israel
    ichilov, HaMerkaz, Israel

    • Coauthor(s)

  • Roy Bitan, MD, MHA

    Lis Hospital for Women’s Health
    Tel Aviv, Tel Aviv, Israel

  • ML

    Michael Lavie, MD

    Ichilov Tel Aviv Israel
    ichilov, HaMerkaz, Israel

  • DM

    Dotan Madar, MD

    Ichilov Tel Aviv Israel
    ichilov, HaMerkaz, Israel

  • AL

    Anat Lavie, MD

    Lis Hospital for Women’s Health, Tel Aviv Sourasky Medical Center
    Lis Hospital for Women’s Health, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel

  • YY

    Yariv Yogev, MD

    Lis Hospital for Women’s Health, Tel Aviv Sourasky Medical Center Gray Faculty of Medicine, Tel Aviv University, Israel
    Lis Hospital for Women’s Health, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel

    • Submitting Author(s)

  • Roza Shperling-Berkovitz, MD, MPH

    Lis Hospital for Women’s Health, Tel Aviv Sourasky Medical Center
    ichilov, HaMerkaz, Israel

Objective:
To characterize labor progression patterns in grand multiparous women with term pre-labor rupture of membranes (PROM).

Study Design:
A retrospective cohort study of all women with singleton term pregnancies (≥37 weeks) and PROM managed expectantly between 2011 and 2023 at a single tertiary medical center. Exclusion criteria were meconium-stained or bloody fluid, non-reassuring fetal heart rate, cesarean delivery, labor induction/augmentation, chorioamnionitis, or incomplete documentation. Participants were stratified into three groups by parity: nulliparous, multiparous, and grand multiparous (≥5 prior births). The primary outcome was the time interval from PROM to spontaneous delivery, defined as the birth of the fetus without pharmacologic or mechanical induction or augmentation. Empirical cumulative distribution functions and bootstrap-generated 95% confidence intervals were used to evaluate labor progression patterns across percentiles.

Results:

1. Among 11,219 eligible women, 4,347 (38.7%)  were nulliparous, 6,725 (59.9%) multiparous, and 147 (1.3%) grand multiparous.

2. Mean PROM-to-delivery intervals were significantly longer in nulliparous women compared to multiparous and grand multiparous women (13.39±11.26 vs 10.22±10.00 and 10.42±11.25 hours, respectively; p < .001).

3. Percentile analysis based on the cumulative proportion of women who had delivered following PROM revealed a biphasic pattern among grand multiparas: up to the 60th percentile (i.e., among the earlier 60% of deliveries), PROM-to-delivery intervals resembled those of multiparas. However, beyond the 70th percentile - among women who had not yet delivered by that point—labor progression slowed, and their delivery intervals began to approximate those of nulliparas

Conclusion:
While grand multiparous women generally experience shorter labor following term PROM, prolonged cases demonstrate a shift toward nulliparous-like patterns. This biphasic progression might inform clinical management.