Comparative study of fetal and maternal outcomes of prelabour rupture of membranes at term
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20164649Keywords:
Fetal and maternal outcomes, PGE1, PROMAbstract
Background: Premature rupture of membranes (PROM) refers to the loss of integrity of membranes before onset of labor, with resulting leakage of amniotic fluid and establishment of communication between the amniotic cavity and the endocervical canal and vagina. The aim of the study was to compare the fetal and maternal outcomes of actively managed and expectantly managed term PROM in a rural setup.
Methods: In this prospective study we included 200 women with diagnosed prelabour rupture of membranes. All women had gestational age >37 weeks and <41 weeks with singleton pregnancy and vertex presentation. Study excluded all patients with previous uterine scar or with any medical or surgical disorder. They were randomly divided in two groups with 100 women each: Group A which was induced with PGE1 or oxytocin depending on their cervical score and Group E which was managed expectantly and late induction after 24 hours was done. Both the groups were given intravenous antibiotics. They were evaluated on the basis of fetal and maternal outcomes.
Results: In this study we found that 70% women who were managed expectantly went in labour within 24 hours of PROM. But PROM to delivery interval was longer in expectantly managed as compared to actively managed or induced group. Rate of cesarean was more in induced group but was statistically insignificant when compared in both the groups. So was NICU admission more in expectant group but was statistically insignificant when compared in both the groups.
Conclusions: Expectant managed can be done in patients with term PROM to reduce the cesarean rate in rural setup. There was no significant difference in maternal and fetal outcomes of the management.
Metrics
References
Larrañaga-Azcárate C, Campo-Molina G, Pérez-Rodríguez AF, Ezcurdia-Gurpegui M. Dinoprostone vaginal slow-release system (Propess) compared to expectant management in the active treatment of premature rupture of the membranes at term: impact on maternal and fetal outcomes. Acta Obstet Gynecol Scand. 2008;87(2):195-200.
Gunn GC, Mishell DR, Morton DG. Premature rupture of the fetal membranes. A review. Am J Obstet Gynecol. 1970;106(3):469-83.
Zamzami TYY. Prelabor rupture of membranes at term in low-risk women: induce or wait? Arch Gynecol Obstet. 2006;273(5):278-82.
Hannah ME, Ohlsson A, Farine D, Hewson SA, Hodnett ED, Myhr TL, et al. Induction of labor compared with expectant management for prelabor rupture of the membranes at term. Termprom Study Group. N Engl J Med. 1996;334(16):1005-10.
Ozden S, Delikara MN, Avci A, Fiçicioglu C. Intravaginal misoprostol vs expectant management in premature rupture of membranes with low Bishop scores at term. Int J Gynaecol Obstet Off Organ Int Fed Gynaecol Obstet. 2002;77(2):109-15.
Flenady V, King J. Antibiotics for prelabour rupture of membranes at or near term. Cochrane Database Syst Rev. 2002;(3):CD001807.
Kodkany BS, Telang MA. Premature rupture of membranes. A study of 100 cases. J Obstet Gynaecol India. 2002;41(4).
Allen SR. Tocolytic therapy in preterm PROM. Clin Obstet Gynecol. 1998;41(4):842-8.
Mercer BM. Preterm premature rupture of the membranes. Obstet Gynecol. 2003;101(1):178-93.
Moberg LJ, Garite TJ, Freeman RK. Fetal heart rate patterns and fetal distress in patients with preterm premature rupture of membranes. Obstet Gynecol. 1984;64(1):60-4.
Jones G. Pre labour rupture of the membrane. In: Arnold Mothhg, editor. Obstetrics and Gynaecology-An evidenced based text for MRCOG: Oxford University press; 2004:297.
Obi SN, Ozumba BC. Pre-term premature rupture of fetal membranes: the dilemma of management in a developing nation. J Obstetr Gynaecol. 2007;27(1):37-40.
Liu J, Feng ZC, Wu J. The incidence rate of premature rupture of membranes and its influence on fetal-neonatal health: a report from Mainland China. J Trop Pediatr. 2009:051.
Knox IC, Hoerner JK. The role of infection in premature rupture of the membranes. Amer J Obstetr Gynecol. 1950;59(1):190-4.
Benirschke K. A review of the pathologic anatomy of the human placenta. American journal of obstetrics and gynecology. 1962;84(11):1595-622.
Polishuk WZ, Palti Z, Rabau E, Lunenfeld B, David A. Pregnancy in a case of Sheehan's syndrome following treatment with human gonadotrophins. BJOG: An Internat J Obstetr Gynaecol. 1965;72(5):778-80.
Lavery JP, Miller CE. Deformation and creep in the human chorioamniotic sac. Amer J Obstetr Gynecol. 1979;134(4):366-75.
Al‐Zaid NS, Bou‐Resli MN, Goldspink G. Bursting pressure and collagen content of fetal membranes and their relation to premature rupture of the membranes. BJOG: An Intern J Obstetr Gynaecol. 1980;87(3):227-9.
Dale PO, Tanbo T, Bendvold E, Moe N. Duration of the latency period in preterm premature rupture of the membranes. Maternal and neonatal consequences of expectant management. Europ J Obstetr Gynecol Repro Bio. 1989;30(3):257-62.
Vadillo-Ortega FE, González-Avila GE, Karchmer S, Cruz NM, Ala-Ruiz AA, Lama MS. Collagen metabolism in premature rupture of amniotic membranes. Obstetr and Gynecol. 1990;75(1):84-8.
Malak TM, Bell SC. Structural characteristics of term human fetal membranes: a novel zone of extreme morphological alteration within the rupture site. BJOG: An Intern J Obstetr Gynaecol. 1994;101(5):375-86.
Parry S, Strauss JF. Premature rupture of the fetal membranes. New Eng J Med. 1998;338(10):663-70.
Gosselink CA, Ekwo EE, Woolson RF, Moawad A, Long CR. Dietary habits, pre-pregnancy weight, and weight gain during pregnancy: Risk of preterm rupture of amniotic sac membranes. Acta Obstet Gynecol Scandinavica. 1992;71(6):425-38.
Ekwo EE, Gosselink CA, Moawad A. Previous pregnancy outcomes and subsequent risk of preterm rupture of amniotic sac membranes. BJOG: An Intern J Obstetr Gynaecol. 1993;100(6):536-41.
Abe T. The detection of the rupture of fetal membranes with the nitrazine indicator. An Intern J Obstetr Gynaecol. 1940;39(3):400-4.
Zondek B, Rozin S. Cervical Mucus Arborization: Its use in the determination of corpus luteum function. J Obstetr Gynaecol. 1954;3(5):463-70.
Borten M, Friedman EA. Amniotic fluid ferning in early gestation. An Intern J Obstetr Gynaecol. 1986;154(3):628-30.
Kappy KA, Cetrulo CL, Knuppel RA, Ingardia CJ, Sbarra AJ, Scerbo JC, et al. Premature rupture of the membranes: a conservative approach. Am J Obstet Gynecol. 1979;134(6):655-61.
Kappy KA, Cetrulo CL, Knuppel RA, Ingardia CJ, Sbarra AJ, Scerbo JC, et al. Premature rupture of the membranes at term. A comparison of induced and spontaneous labors. J Reprod Med. 1982;27(1):29-33.
Alcalay M, Hourvitz A, Reichman B, Luski A, Quint J, Barkai G, et al. Prelabour rupture of membranes at term: early induction of labour versus expectant management. Eur J Obstet Gynecol Reprod Biol. 1996;70(2):129-33.
Shalev E, Peleg D, Eliyahu S, Nahum Z. Comparison of 12- and 72-hour expectant management of premature rupture of membranes in term pregnancies. Obstet Gynecol. 1995;85(5 Pt 1):766-8.
Hjertberg R, Hammarström M, Moberger B, Nordlander E, Granström L. Premature rupture of the membranes (PROM) at term in nulliparous women with a ripe cervix. A randomized trial of 12 or 24 hours of expectant management. Acta Obstet Gynecol Scand. 1996;75(1):48-53.
Akyol D, Mungan T, Unsal A, Yüksel K. Prelabour rupture of the membranes at term-no advantage of delaying induction for 24 hours. Aust N Z J Obstet Gynaecol. 1999;39(3):291-5.
Hodnett ED, Hannah ME, Weston JA, Ohlsson A, Myhr TL, Wang EE, et al. Women’s evaluations of induction of labor versus expectant management for prelabor rupture of the membranes at term. Term PROM Study Group. Birth Berkeley Calif. 1997;24(4):214-20.
McCaul JF, Rogers LW, Perry KG, Martin RW, Allbert JR, Morrison JC. Premature rupture of membranes at term with an unfavorable cervix: comparison of expectant management, vaginal prostaglandin, and oxytocin induction. South Med J. 1997;90(12):1229-33.
Ben-Haroush A, Yogev Y, Glickman H, Bar J, Kaplan B, Hod M. Mode of delivery in pregnancies with premature rupture of membranes at or before term following induction of labor with vaginal prostaglandin E2. Am J Perinatol. 2004;21(5):263-8.
Ezra Y, Michaelson-Cohen R, Abramov Y, Rojansky N. Prelabor rupture of the membranes at term: when to induce labor? Eur J Obstet Gynecol Reprod Biol. 2004;115(1):23-7.
da Graça Krupa F, Cecatti JG, de Castro Surita FG, Milanez HMBP, Parpinelli MA. Misoprostol versus expectant management in premature rupture of membranes at term. BJOG Int J Obstet Gynaecol. 2005;112(9):1284-90.
Lin MG, Nuthalapaty FS, Carver AR, Case AS, Ramsey PS. Misoprostol for labor induction in women with term premature rupture of membranes: a meta-analysis. Obstet Gynecol. 2005;106(3):593-601.
Dare MR, Middleton P, Crowther CA, Flenady VJ, Varatharaju B. Planned early birth versus expectant management (waiting) for prelabour rupture of membranes at term (37 weeks or more). Cochrane Database Syst Rev. 2006;(1):CD005302.
Ayaz A, Saeed S, Farooq MU, Ahmad F, Bahoo LA, Ahmad I. Pre-labor rupture of membranes at term in patients with an unfavorable cervix: active versus conservative management. Taiwan J Obstet Gynecol. 2008;47(2):192-6.
Shanthi K, Devi PG, Bharathi T, Chandrasekharan PA. Comparative study of active versus expectant management and maternal and neonatal outcome in premature rupture of the membranes (PROM) in Tertiary Care Hospital, Tirupathi. IOSR-JDMS. 2015;14(4):34-9.
El Fekih C, Ouerdiane N, Mrezguia C, Mourali M, Douagi M, Abdennebi M, et al. Premature rupture membrane at term with unfavourable cervix. Tunis Médicale. 2009;87(9):603-6.
J V, G V. A Study of feto-maternal outcome in patients with prelabour rupture of membranes at term and gt;37 Weeks. Med Sci Int Med J. 2012;1(2):118.
Shah K, Doshi H. Premature rupture of membrane at term: early induction versus expectant management. J Obstet Gynecol India. 2012;62(2):172-5.
Mbaluka CM, Kamau K, Karanja JG, Mugo N. Effectiveness and safety of 2-hourly 20 mcg oral misoprostol solutions compared to standard intravenous oxytocin in labour induction due to pre-labour rupture of membranes at term: a randomised clinical trial at kenyatta national hospital. East Afr Med J. 2014;91(9):303-10.
Pintucci A, Meregalli V, Colombo P, Fiorilli A. Premature rupture of membranes at term in low risk women: how long should we wait in the latent phase? J Perinat Med. 2014;42(2):189-96.
Sadeh-Mestechkin D, Samara N, Wiser A, Markovitch O, Shechter-Maor G, Biron-Shental T. Premature rupture of the membranes at term: time to reevaluate the management. Arch Gynecol Obstet. 2016.
Chaudhuri S, Kumar BP, Bhattacharyya S, Nath M. Premature rupture of membranes at term : immediate induction with PGE2 gel compared with delayed induction with oxytocin. J Obstet Gynecol India. 2006;56(3).
Yaqub U. Obstetric and perinatal outcome in induction of labor compared with expectant management for prelabor rupture of the membranes at term. Mushtaq R, editor. Pak Armed Forces Med J. 2015;65(2):179-83.
