Comparison of immediate versus late induction in premature rupture of membranes with oral prostaglandins in term patients
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20262522Keywords:
Induction, Misoprostol, Membrane ruptureAbstract
Background: Immediate induction involves initiating labor as soon as prelabor rupture of membranes (PROM) is confirmed to minimize infection risk and complications associated with prolonged membrane rupture, including chorioamnionitis. This study aimed to compare maternal and neonatal outcomes in terms of PROM-delivery interval, mode of delivery, maternal and neonatal morbidity following immediate and delayed induction in PROM.
Methods: This prospective cohort study included 200 patients. Group A (100 patients) underwent immediate induction following PROM with oral PGE1, while group B (100 patients) underwent induction 6 hours after PROM with oral PGE1. A maximum of three doses of PGE1 (50 mcg) were administered over 24 hours. Intermittent fetal heart monitoring using CTG was performed, maternal and fetal complications were recorded and managed accordingly. Results were compared between groups.
Results: The efficacy of oral PGE1 as an induction agent at 2 hours and 6 hours post-PROM was assessed based on PROM - delivery interval, duration of first stage of labor, and vaginal delivery within 24 hours. In the early induction group, 80% delivered within 24 hours compared to 56% in the delayed group. Only 3.5% in the early group required three doses versus 9% in the delayed group. Normal vaginal delivery occurred in 96% of early induction cases and 91% of delayed cases. Maternal pyrexia and sepsis were carefully monitored.
Conclusions: Early induction at 2 hours after PROM reduces PROM-delivery interval and improved the outcome of delivery, maternal satisfaction rates including lesser maternal and neonatal morbidity.
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