A comparative study between active and expectant management of premature rupture of membranes at term on fetomaternal and perinatal outcome in rural population
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20182356Keywords:
Labour induction, Latent period, PROMAbstract
Background: Premature rupture of membranes at term (PROM) is defined as a spontaneous rupture of membranes after 37 completed weeks of gestation and before the onset of regular painful uterine contractions. PROM occurs in 5-10% of all pregnancies of which approximately 80% occur at term. The study aimed to compare the maternal and neonatal outcome in patients with term PROM receiving active induction versus expectant management.
Methods: The present study was a prospective randomised controlled trial, conducted on 100 term antenatal women with PROM in the Department of Obstetrics and Gynaecology, UPUMS, Saifai from January 2016 to June 2017. 50 antenatal women received immediate induction with oral misoprostol while another 50 antenatal women were expectantly managed for 24 hours. The latency period, PROM delivery interval, maternal and neonatal outcome were compared and subjected to statistical analysis.
Results: 42% of active management group and 30% of expectant management group had a latency period of 12-20 hours and results were found to be statistically significant (p value = 0.005). There was no statistically significant difference in the rate of caesarean section, maternal and neonatal morbidity in both the groups.
Conclusions: Immediate labour induction in patients with term PROM resulted in significant shortening of latent period and PROM to delivery interval without any increase in caesarean section rate as compared to expectant management group.
References
Mead PB. Management of the patient with premature rupture of the membranes. Clinics Perinatol. 1980;7:243-55.
Parry S, Strauss JF. Mechanism of disease: premature rupture of the fetal membranes. N Engl J Med. 1998;338:663-70.
Larranaga-Azcarate C, Campo-Molina G, Perez- Rodriguez AF. Dinoprostone vaginal slow release system compared to expectant management in the active treatment of PROM at term: impact on maternal and foetal outcome. Actaobstetrica. 2008;87:195-200.
James R, Philip SJ, Disuia CB, Hammond WN. Etiology of premature rupture of membranes. In: James R, Scott Philip J, Disuia CB, Hammond WN (editors) Danforth’s Obstetrics and Gynaecology. 8th ed. New York: Lippncott Williams and Wilkins; 2000:269-70.
Ozden S, Delikara MN, Avci A. Intravaginal misoprostol vs expectant management in PROM with low Bishop scores at term. Int J obstet. 2002;77:109-15.
Midan MF. Early versus delayed induction following prelabour rupture of memebranes at term. AAMJ. 2012;10(2):367-81.
Mukharya J, Mukharya S. Comparative study of fetal and maternal outcomes of prelabour rupture of membranes at term. Int J Reprod Obstet Gynecol. 2017;6(1):149-163.
Butt KD, Bennett KA, Young DC. Randomized comparison of oral misoprostol and oxytocin for labour induction in term prelabour rupture of the menbranes. Obstet Gynecol. 1999;94(6):994-9.
Kunt C, Pektas M, Cakir A. Randomized trial of vaginal prostaglandin E2 versus oxytocin for labour induction in term premature rupture of the membrane. Taiwan J Obstet Gynecol. 2010;49(1):57-9.
Vaishnav J, Vaishnav G. A study of feto-maternal outcome in patients with pre-labour rupturevof membranes at term (>37 weeks). Med Sci. 2011;1(2):118-24.
Gracekrupa F, Cecatti JG, de Castro Surita FG. Misoprostol versus expectant management in premature rupture of membranes at term. BJOG. 2005;112:1284-90.
Shetty A, Stewart K, Stewart G. Active management of term prelabour rupture of the membranes at term with oral misoprostol. Br J Obstet Gynecol. 2002;109(6):645-50.
Crane J, Delany T and Hutchens D. Oral misoprostol for premature rupture of membranes at term. Am J Obstet Gynecol. 2003;189(3):720-4.
Chaudhari S, Kumar BP, Bhattacharyya S, Nath M. Premature rupture of membrane at term: immediate induction with PGE2 gel compared with delayed induction with oxytocin. J Obstet Gynecol India. 2006;56(3):224-9.
Krupa S, Haresh D. Premature rupture of membrane at term: early induction versus expectant management. J Obstet Gynecol. 2012;62(2):172-5.