Premature rupture of membranes at term: Early induction versus expectant management

Abstract

Introduction: Premature rupture of the membranes at term is spontaneous rupture of the membranes after 37 wks of the gestations and before the onset of the regular painful uterine contractions. It occurs in ten percent of cases and managed either expectantly or actively. Objective: The present research was undertaken to study the effectiveness of early labor induction and to assess maternal and fetal outcome in term pregnancy with cervical PGE2 versus expectant management. Materials and Methods: This was a randomised control trial conducted in the Department of Obstetrics and Gynaecology from October 2014 to September 2016 on a sample size of 144. They were divided into two groups – Group A containing subjects with expectant management and Group B with subjects who were induced with intracervical PGE2 and their outcome was compared. Results: In group A, 70.83% of cases spontaneous labours started within 24 hrs and in those with induction 56.94% were successful. Of the spontaneously delivered 65.28% were primi with 58.33% having favourable Bishop Score. In those with induction 73.61% were primi with 56.94% having favourable Bishop Score. Conclusion: Early induction of labour in cases of PROM at term with PGE-2 GEL resulted in reduction of latency of labour but also increased operative intervention. Expectant line has greater maternal and neonatal morbidity. Keywords: Amniotic fluid, Expectant management, Intracervical PGE2, Premature rupture of membrane, Term pregnancy.