Premature Rupture of Membrane at Term: Early Induction Versus Expectant Management

Abstract

Premature rupture of membrane is managed either expectantly or actively. The purpose of the study was to assess the effectiveness of early labor induction with cervical prostaglandin E2 versus expectant management in women with term premature rupture of membrane. Singleton pregnancy cases with cephalic presentation reported between 37 and 41weeks of pregnancy with PROM of <6h and cervical dilatation <3cm were studied over a period of 2years. Out of 100 patients studied, half of them were managed by expectant protocol and the other half by early induction within 6h of PROM with intracervical gel. Main outcomes measured were PROM-delivery interval, mode of delivery, neonatal and maternal morbidity, and period of maternal and/or neonatal hospitalization. Chi-square test was used to compare frequencies between two groups. Differences between means of other measurement were compared by independent t test. PROM-delivery interval was 22h in expectant group, while in early induction group, it was 13h (p value<0.001). Rate of cesarean section remained almost same in both groups. Increases in maternal-neonatal infection rate and hospital stay were noted in expectant group; however, this was not statistically significant. Immediate labor induction with prostaglandin in cases of term PROM shortens delivery interval and maternal hospital stay with reduction in maternal-neonatal sepsis.