Offering induction of labor for 22-week premature rupture of membranes: a survey of obstetricians

Objective:to describe obstetricians’ induction counseling practices for 22-week preterm premature rupture of membranes (pprom) and identify provider characteristics associated with offering induction.methods:surveyed 295 obstetricians on their likelihood (0–10) of offering induction for periviable pprom across 10 vignettes. twenty-two-week vignettes were analyzed, stratified by parental resuscitation preference. bivariate analyses identified physician characteristics associated with reported likelihood ratings.results:obstetricians (n=205) were not likely to offer induction. median ratings by preference were as follows: resuscitation 1.0, uncertain 1.0 and comfort care 3.0. only 41% of obstetricians were likely to offer induction to patients desiring comfort care. in addition, several provider-level factors, including practice region, parenting status and years in practice, were significantly associated with offering induction.conclusions:obstetricians do not readily offer induction when counseling patients with 22-week ruptured membranes, even when patients prefer palliation. this may place women at risk for infectious complications without accruing a neonatal benefit from prolonged latency.