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.