A Clinical Study on Expectant Management versus Induction of Labour in term Premature Rupture of Membranes (PROM)
Jayati Nath
Abstract
Jayati Nath
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.
Key concepts: Prom, Premature rupture of membranes, Vaginal infections, Pelvic inflammatory disease, Expectant management, Medicine, Maternal-fetal medicine, Obstetrics