Comparison of Maternal and Neonatal Outcome of Induction of Labour with Expectant Management in Patients with term Prelabour Rupture of Membranes

Abstract

Objective: To compare the maternal and neonatal outcomes of induction of labour with expectant management in patients
with term prelabour rupture of membranes.

Study Design: Quasi-experimental study.

Place and Duration of Study: Labour ward of department of Gynecology and Obstetrics, Pak Emirates Military Hospital, Rawalpindi Pakistan, from May to Nov 2017.

Methodology: A total of 1800 women with term (gestational weeks ≥37 weeks assessed on Last menstrual period) premature rupture of membrane between 20-35 years were included. Patients with twin pregnancy, suspected or confirmed chorioamnionitis and scarred uterus were excluded. Patients were randomly allocated either to active (Group-A) or expectant management group (Group-B) by table of random numbers. Mode of delivery, APGAR score, neonatal sepsis and development of chorioamnionitis was recorded for both the groups within first 24 hours after birth.

Results: In our study, mode of delivery in Induced Group was spontaneous vaginal delivery in 819(91.0%) and caesarean section in 81(9.0%) whereas mode of delivery in Expectant Group was spontaneous vaginal delivery and caesarean section in 776(86.22%) and 124(13.78%) respectively. Neonatal sepsis was 144(16.0%) in Expectant Group and 104(11.56%) in Induced Group. Chorioamnionitis was 161(17.89%) in expectant group and 92(10.22%) in Induced Group. APGAR <7 at 1 minute was 204(22.67%) in Expectant and 174(19.33%) in Induced Group. APGAR <7 at 5 minutes was 91(10.11%) in expectant and 71(7.89%) in induced group.

Conclusion: This study concluded that management outcome of induction of labor in term prelabor rupture of membranes is better than expectant management.