Publication:

Comparative study of fetal and maternal outcomes of prelabour rupture of membranes at term

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.