EARLY PLANNED BIRTH: A BETTER WAY TO MANAGE PRE-LABOR RUPTURE OF MEMBRANES AT TERM

Abstract

Objective: To compare mean pre-labour rupture of membranes (PROM)-delivery time, hospital stay, frequency of caesarean section and fetal distress associated with immediate induction versus expectant management with delayed induction in women presenting with pre-labour rupture of membranes at term. Study Design: Quasi-experimental study. Place and Duration of Study: Gynae/Obs. Unit of Shifa International Hospital, Islamabad, from Sep 2013 to Mar 2014. Methodology: A total of 294 pregnant females with gestational age between 37-41 weeks with singleton pregnancies and cephalic presentation presenting with pre-labour rupture of membranes were enrolled and equally distributed to two groups. Group A females were immediately induced with 50 micrograms of misoprostol per vaginally and group B was managed expectantly for 12 hours followed by labor induction with 50 micrograms of misoprostol per vaginally if labor did not ensue spontaneously in 12 hours. Results: Mean pre-labour rupture of membranes to delivery time was significantly shorter in immediate induction group when compared to the expectant group with delayed induction (6.93 ± 2.43 versus 19.25 ± 5.38 hours, p=0.001). Frequency of hospital stay of >3 days was also significantly lower in immediate induced group (29.9% n=44/147 versus 40.1% n=59/147, p=0.036). Higher percent-age of caesarean section (53.7% n=79/147 versus 44.9% n=66/147, p=0.129) and fetal distress (46.3% n=68/147 versus 38.8% n=57/147, p=0.129) were observed in immediate induction group. Conclusion: The mean pre-labour rupture of membranes to delivery interval and hospital stay was significantly less in immediate induction when compared to expectant management with delayed induction group. Rates of caesarean sections and...................

Keywords

• expectant management
• feto-maternal outcomes
• labor induction
• pre-labour rupture of membranes