Title: A Comparative Study of Immediate Induction and Twelve Hour Expectant Management of Labour in Term Premature Rupture of Membranes
Authors: Dr Deepthy Balakrishnan, Dr Lakshmi Sadasivan
DOI: https://dx.doi.org/10.18535/jmscr/v6i1.94
Abstract
Context: PROM –immediate induction and expectant management.
Aims: 1. To compare the management of women with term premature rupture of membranes in the immediate induction group and twelve hour expectant management group.
- To study the maternal and neonatal outcomes in these groups
Settings and Design: This was a prospective study conducted in the obstetrics and gynecology department, Government Medical college hospital, Trivandrum.
Material and Methods: This is a prospective study of 100 cases of singleton pregnancies with term PROM where 50 cases were allotted at random to group A [ immediate induction of labour after PROM] and 50 cases were allotted to group B [expectant management for 12 hours].
Statistical Analysis: The tests used were chi-square test, student’s t test, test of proportions and Fischer’s exact test.
Results: There was no statistically significant difference in the PROM delivery interval in both groups. Maternal morbidity and fetal morbidity were similar in both groups. The differences in caesarean section rates between the two groups were found to be not statistically significant. In delayed induction groups 41 % of primigravidas and 50% of multigravidas went in to spontaneous labour within 12 hours. Of these, 8 (23.5%) primis and 2 (12. 5 %) multi gravidas required augmentation with oxytocin. While 17.6 %0f primi gravidas and 37.5 % of multi gravidas delivered without the need of oxytocin.
Conclusion: In term pregnancies with PROM, it is not necessary to hasten the induction of labour. A delay of 12 hours will allow many women to go in to labour spontaneously and reduce the need for induction with no increase in caesarean section rate and maternal and neonatal morbidity.
Keywords: PROM, Expectant management, maternal outcome.
Key message: In term of labour pregnancies with PROM, it is not necessary to hasten the induction.
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