Comparative study of induction in primigravida with prom and those with intact membrane at term

Abstract

Introduction: Induction of labour is the most common procedures in obstetrics. An elective induction is defined as the direct initiation of labour without a medical or obstetrical reason. Women at term generally present with more favourable cervix. Elective induction at term does not seem to pose an increased risk to the women and to her foetus in carefully selected populations. Material and Methods: Total 200 primigravida cases were studied, were divided into 2 groups, 100 with prelabour rupture of membranes and 100 with intact membrane. elective induction with dinoprostone gel instillation pervaginally/intracervically was done in both the groups with unfavourable cervix and comparative study was done in terms of - Mode of delivery, Induction delivery interval, Caesarean section rate and failure of induction, Maternal complications and neonatal outcome. Results: Mean gestational age in group A was 38.37 weeks while in group B was 38.5 weeks. Mean induction delivery interval in group A was 8.61 hours and in group B was 8.71 hours. In group A 52% women had vaginal delivery while 48% women delivered by caesarean section. In group B with intact membranes 72% women delivered by vaginal route while 28% women delivered by LSCS. C-section rate was more in PROM group. Incidence of maternal complications in both the groups differed slightly. In present study APGAR score at 5 min of majority of newborn was more than 8. Conclusion: In conclusion labour induction for PROM at term in nulliparous women with an unfavourable cervix is associated with longer duration of second stage of labour and a higher risk of caesarean delivery for failure to progress in comparison with intact membrane group.