{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T08:16:18Z","timestamp":1783671378085,"version":"3.55.0"},"reference-count":25,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,12,19]],"date-time":"2024-12-19T00:00:00Z","timestamp":1734566400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004212","name":"P\u00e4ivikki ja Sakari Sohlbergin S\u00e4\u00e4ti\u00f6","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004212","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008376","name":"Helsingin ja Uudenmaan Sairaanhoitopiiri","doi-asserted-by":"publisher","award":["Y231N00244"],"award-info":[{"award-number":["Y231N00244"]}],"id":[{"id":"10.13039\/100008376","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Pre\u2010labor rupture of membranes (PROM) occurs in about 8% of term pregnancies with over 70% delivering spontaneously within 24\u2009h. However, prolonged PROM increases the risk of chorioamnionitis and neonatal sepsis. While misoprostol and oxytocin are considered safe and effective methods of labor induction, most guidelines do not encourage balloon catheter (BC) use following PROM given concerns about increased risk of chorioamnionitis. However, lack of robust evidence exists. This study aimed to compare BC and low\u2010dose oral misoprostol (OM) regarding infectious morbidity and assess the impact of routine antibiotic prophylaxis during BC use on infection prevention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and Methods<\/jats:title><jats:p>A randomized controlled trial comparing BC and low\u2010dose 25\u2009\u03bcg OM for pre\u2010induction cervical ripening in an inpatient setting and assessing the preventive effect of prophylactic antibiotics during BC use in 175 women with PROM was carried out between 1.2.2021 and 31.12.2023 in Helsinki University Hospital. The study protocol was registered in the ISCTN registry (ISRCTN10972090). The primary outcome measures of the study were the mode of delivery, and maternal and neonatal infections.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eighty\u2010nine women (50.9%) were allocated in the BC arm and 86 women (49.1%) in the OM arm. The cesarean delivery rates were comparable (BC 19.1% [<jats:italic>n<\/jats:italic>\u2009=\u200917] vs. OM 11.6% [<jats:italic>n<\/jats:italic>\u2009=\u200910]; <jats:italic>p<\/jats:italic>\u2009=\u20090.17). The rate of chorioamnionitis (BC 9.1% [<jats:italic>n<\/jats:italic>\u2009=\u20098] vs. OM 3.5% [<jats:italic>n<\/jats:italic>\u2009=\u20093]; <jats:italic>p<\/jats:italic>\u2009=\u20090.21) or neonatal infection (BC 4.5% [<jats:italic>n<\/jats:italic>\u2009=\u20094] vs. OM 2.3% [<jats:italic>n<\/jats:italic>\u2009=\u20092]; <jats:italic>p<\/jats:italic>\u2009=\u20090.68) were not statistically significantly different between the groups, although there was a trend towards higher frequency of infections in the BC arm. There were no differences in the incidence of chorioamnionitis or neonatal infections when routine antibiotic prophylaxis was administered during the BC use compared to those who did not receive antibiotics (chorioamnionitis 10.9% with antibiotics vs. 8.0% without antibiotics; <jats:italic>p<\/jats:italic>\u2009=\u20090.68, and neonatal infection 5.3% vs. 3.9%; <jats:italic>p<\/jats:italic>\u2009=\u20091.00). Maternal childbirth satisfaction was similar in the BC and OM groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our results showed almost threefold frequency of chorioamnionitis and twofold frequency of neonatal infections following the use of BC compared to OM, although the study was underpowered for reaching statistical significance. The use of prophylactic antibiotics during BC retention did not reduce the incidence of infections.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.15036","type":"journal-article","created":{"date-parts":[[2024,12,19]],"date-time":"2024-12-19T08:43:38Z","timestamp":1734597818000},"page":"400-407","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Comparison of balloon catheter and oral misoprostol for cervical ripening in women with pre\u2010labor rupture of membranes: A Finnish randomized controlled trial"],"prefix":"10.1111","volume":"104","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0350-7088","authenticated-orcid":false,"given":"Heidi","family":"Kruit","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Helsinki University Hospital and University of Helsinki  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4507-6917","authenticated-orcid":false,"given":"Leena","family":"Rahkonen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Helsinki University Hospital and University of Helsinki  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,12,19]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199604183341601"},{"key":"e_1_2_13_3_1","first-page":"CD005302","article-title":"Planned early birth versus expectant management (waiting) for prelabour rupture of membranes at term (37\u2009weeks or more)","volume":"1","author":"Middleton P","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000003700"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajogmf.2023.101094"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajogmf.2021.100425"},{"key":"e_1_2_13_7_1","first-page":"1519","article-title":"Induction of labour versus expectant management for prelabour rupture of the membranes at term: an economic evaluation. TERMPROM study group. Term Prelabour rupture of the membranes","volume":"157","author":"Gafni A","year":"1997","journal-title":"CMAJ"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000172425.56840.57"},{"key":"e_1_2_13_9_1","article-title":"Prostaglandins for prelabour rupture of membranes at or near term","volume":"1997","author":"Tan BP","year":"2000","journal-title":"Cochrane Database Syst Rev"},{"issue":"10","key":"e_1_2_13_10_1","article-title":"Vaginal misoprostol for cervical ripening and induction of labour","author":"Hofmeyr GJ","year":"2010","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2021.03.002"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0036-1580608"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.13856"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-10-81"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-015-0513-4"},{"key":"e_1_2_13_16_1","first-page":"714","article-title":"CEQ\u2010FI\u2013 a validated tool for measuring the childbirth experience","volume":"76","author":"Toivonen E","year":"2021","journal-title":"The Finnish Medical Journal (L\u00e4\u00e4k\u00e4rilehti)"},{"key":"e_1_2_13_17_1","unstructured":"HauhioN HeinoA GisslerM.Perinatal statistics: Parturients Deliveries and Newborns 2022. Official Statistics of Finland Perinatal statistics. The Finnish Institute for Health and Welfare (THL).2023(https:\/\/thl.fi\/tilastot\u2010ja\u2010data\/tilastot\u2010aiheittain\/seksuaali\u2010ja\u2010lisaantymisterveys\/synnyttajat\u2010synnytykset\u2010ja\u2010vastasyntyneet\/perinataalitilasto\u2010synnyttajat\u2010synnytykset\u2010ja\u2010vastasyntyneet)"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-060161"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2023.02.002"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000001002"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1159\/000009986"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.7556\/jaoa.2014.137"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.4103\/abr.abr_78_23"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000002374"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2017.04.038"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1517\/14656566.2015.983077"}],"container-title":["Acta Obstetricia et Gynecologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.15036","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T22:39:49Z","timestamp":1741732789000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/aogs.15036"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,19]]},"references-count":25,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,2]]}},"alternative-id":["10.1111\/aogs.15036"],"URL":"https:\/\/doi.org\/10.1111\/aogs.15036","archive":["Portico"],"relation":{},"ISSN":["0001-6349","1600-0412"],"issn-type":[{"value":"0001-6349","type":"print"},{"value":"1600-0412","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,19]]},"assertion":[{"value":"2024-04-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-01","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}