Outcome of Early and Late Induction of Labour in Premature Rupture of Membranes
Keywords:Cesarean section, Chorioamnionitis, Induction of labour, Neonatal sepsis, Premature rupture of membranes, Term gestation
Objective: To determine the frequency of early and late labour induction in premature rupture of membranes and compare their outcome.
Study Design: Cross sectional study.
Place and Duration of Study: Department of Obstetrics & Gynaecology, Combined Military Hospital, Rawalpindi Pakistan,from Jan-Dec 2021.
Methodology: One hundred and sixty-four pregnant women aged 18-35 years, with uncomplicated pregnancies at gestational age ≥37 weeks to ≤40 weeks with premature rupture of membranes, were included. All primigravida and multiparous with previous normal vaginal deliveries were selected. Patients were selected with reactive CTG, adequate pelvis, clear liquor and vertex presentation. Induction of labour achieved with cervical Prostaglandin E2. Labour was monitored accordingly.
Results: Seventy-four women (45%) presented (and got induction of labour) within 12 hours of premature rupture of membranes (early induction of labour), while 90(55%) fell under late induction of labour. 35(21%) were delivered by instrumental vaginal delivery, while 31(19%) were delivered by caesarian section. The most common indication of the caesarian section was fetal distress (36%), followed by poor progress of labour (32%). Patients with early induction of labour witnessed less chorioamnionitis (7% vs 18%) and post-partum haemorrhage (8% vs 13%). Likewise, with early induction of labour incidence of neonatal sepsis was less (3% vs 10%) with limited poor APGARs at birth (3% vs 12%). No early neonatal death was observed in 164 cases.
Conclusion: For women with term premature rupture of membranes, earlier induction of labour results in lower maternal and fetal morbidity.