Details about the counseling women receive regarding termina-
tion of pregnancy as an alternative to expectant management of
22-week PPROM represent a gap in the current literature. Previous
work has documented that, when offered, as many as 50% of
women presenting with PPROM elect to terminate the pregnancy
to avoid poor maternal or fetal outcomes.8 However, patients
cannot choose options about which they are not informed. As the
threshold for intervention and resuscitation moves to earlier
gestational ages, it is unclear whether obstetricians are currently
offering patients the option of labor induction for pregnancy
termination as an alternative to expectant management at the
lower limits of viability. Little is known about the factors that
influence an obstetrician’s willingness to offer induction or the
extent to which this counseling practice is dependent on a
patient’s preference for resuscitation or palliation. Therefore, the
purpose of this study was to explore obstetricians’ induction
counseling practices for patients presenting with PPROM at
22 weeks GA when patients voice different preferences for resusci-
tative care. More specifically, we aimed to, first, determine an
obstetricians’ overall likelihood of offering induction, then identify
provider and practice setting characteristics associated with
likelihood of offering induction.
Details about the counseling women receive regarding termina-tion of pregnancy as an alternative to expectant management of22-week PPROM represent a gap in the current literature. Previouswork has documented that, when offered, as many as 50% ofwomen presenting with PPROM elect to terminate the pregnancyto avoid poor maternal or fetal outcomes.8 However, patientscannot choose options about which they are not informed. As thethreshold for intervention and resuscitation moves to earliergestational ages, it is unclear whether obstetricians are currentlyoffering patients the option of labor induction for pregnancytermination as an alternative to expectant management at thelower limits of viability. Little is known about the factors thatinfluence an obstetrician’s willingness to offer induction or theextent to which this counseling practice is dependent on apatient’s preference for resuscitation or palliation. Therefore, thepurpose of this study was to explore obstetricians’ inductioncounseling practices for patients presenting with PPROM at22 weeks GA when patients voice different preferences for resusci-tative care. More specifically, we aimed to, first, determine anobstetricians’ overall likelihood of offering induction, then identifyprovider and practice setting characteristics associated withlikelihood of offering induction.
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