Management of Rupture of Membranes at Term in Low-Risk Obstetric Population

Abstract

Objective To compare (he outcomes of expectant versus active management of patleuts presenting with premature rupture of membranes (PROM) at term. Design: Observational ase-conLrol study over a period of 30 months. Setting: King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Subjects: All obstetric patients with no obstetric risk factors other than PROM at term were included in th’g present study. Each patient was matched with a control case who had started labor with intact membranes. Outcome Measures: Duration of labor, fetal distress, intrapartum pyrexia, rate of cesarean section delivery, and Apgar scores at birth. Results: The duration of labor was shorter in patients with PROM compared to the control group, but (he difference was not statistically significant. Furthermore, cesarean section rate was 4.5% in the PROM group versus 7,6% in the control group. Among patients with PROM who received active management, the rates of intrapartum pyrexia and cesarean sections were almost twice that in patients who were managed expectantly. Conclusion: In the absence of other maternal and/or obstetric risk factors, PROM does not seem to constitute additional obstetric risks. Furthermore, expect nt management of PROM in anticipation of spontaneous uterine contractions increases the changes of normal delivery without an increase in fetal and/ or maternal morbidity. Keywords: PROM, Fetal distress, Emergency cesarean section.