2016•Obstetrics & Gynecology International JournalRequires access

A Clinical Study on Expectant Management versus Induction of Labour in term Premature Rupture of Membranes (PROM)

Jayati Nath

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Abstract

Premature rupture of membranes (PROM), also called Prelabour Rupture Of Membranes, is classically defined as rupture of membranes before labour and accounts for 0.8-0.9% of all pregnancies at term.This study was conducted over a period of 14 months (from March 2015 to May 2016) in a tertiary care medical college in North India.A total of 100 term PROM patients were recruited in our study -divided into two groups randomly--50 (Group A) patients were managed conservatively and 50 (Group-B) patients underwent induction of labour.Both these patient groups were studied to compare the feto-maternal outcome.Group-A (conservative management group) patients were observed to await the spontaneous onset of labour pains for at least 24 hours.Patients in group B were induced with either -PGE1 tab (misoprostol) 25 µgm 4 hourly orally or iv oxytocin infusion.The PROM-delivery interval was < 12 hours in 72 % of induced groups (Group B) and 10% (5) in group-A (conservative or expectant group).LSCS rate was 10 % in group-A (expectant group) &15 % in group -B (induced group).Sepsis rate, maternal and fetal, hospital stay, NICU admission & duration of NICU stay were notably higher in group -A (expectant management group).Therefore, from our study we concluded that immediate induction of labour in term PROM cases shortens the PROM-delivery interval, hospital stay, NICU stay and reduction in both maternal & neonatal sepsis.

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Premature rupture of membranes (PROM), also called Prelabour Rupture Of Membranes, is classically defined as rupture of membranes before labour and accounts for 0.8-0.9% of all pregnancies at term.This study was conducted over a period of 14 months (from March 2015 to May 2016) in a tertiary care medical college in North India.A total of 100 term PROM patients were recruited in our study -divided into two groups randomly--50 (Group A) patients were managed conservatively and 50 (Group-B) patients underwent induction of labour.Both these patient groups were studied to compare the feto-maternal outcome.Group-A (conservative management group) patients were observed to await the spontaneous onset of labour pains for at least 24 hours.Patients in group B were induced with either -PGE1 tab (misoprostol) 25 µgm 4 hourly orally or iv oxytocin infusion.The PROM-delivery interval was < 12 hours in 72 % of induced groups (Group B) and 10% (5) in group-A (conservative or expectant group).LSCS rate was 10 % in group-A (expectant group) &15 % in group -B (induced group).Sepsis rate, maternal and fetal, hospital stay, NICU admission & duration of NICU stay were notably higher in group -A (expectant management group).Therefore, from our study we concluded that immediate induction of labour in term PROM cases shortens the PROM-delivery interval, hospital stay, NICU stay and reduction in both maternal & neonatal sepsis.

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Available abstract

Premature rupture of membranes (PROM), also called Prelabour Rupture Of Membranes, is classically defined as rupture of membranes before labour and accounts for 0.8-0.9% of all pregnancies at term.This study was conducted over a period of 14 months (from March 2015 to May 2016) in a tertiary care medical college in North India.A total of 100 term PROM patients were recruited in our study -divided into two groups randomly--50 (Group A) patients were managed conservatively and 50 (Group-B) patients underwent induction of labour.Both these patient groups were studied to compare the feto-maternal outcome.Group-A (conservative management group) patients were observed to await the spontaneous onset of labour pains for at least 24 hours.Patients in group B were induced with either -PGE1 tab (misoprostol) 25 µgm 4 hourly orally or iv oxytocin infusion.The PROM-delivery interval was < 12 hours in 72 % of induced groups (Group B) and 10% (5) in group-A (conservative or expectant group).LSCS rate was 10 % in group-A (expectant group) &15 % in group -B (induced group).Sepsis rate, maternal and fetal, hospital stay, NICU admission & duration of NICU stay were notably higher in group -A (expectant management group).Therefore, from our study we concluded that immediate induction of labour in term PROM cases shortens the PROM-delivery interval, hospital stay, NICU stay and reduction in both maternal & neonatal sepsis.

Key concepts: Prom, Premature rupture of membranes, Vaginal infections, Pelvic inflammatory disease, Expectant management, Medicine, Maternal-fetal medicine, Obstetrics

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