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  3. 2. A Comparison of 24 Hours Expectant Management Versus Induction of Labour in Pre-Labour Rupture of Membranes at Term
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2. A Comparison of 24 Hours Expectant Management Versus Induction of Labour in Pre-Labour Rupture of Membranes at Term

Kanwal Bashir1, Sarwat Navid2 and Azra Saeed Awan1

ABSTRACT

Objective: To compare the outcome of 24 hours expectant management with early induction in prelabour rupture of membranes at term.

Study Design: Quasi-Experimental Study

Place and Duration of Study: This study was conducted at the Obstet and Gynae, Fauji Foundation Hospital, Rawalpindi from January 2016 to December 2016.

Materials and Methods: This study was conducted on 120 patients with 37-41 weeks gestation, parity upto 5, having a single cephalic fetus presenting within 8 hours of uncomplicated PROM. Patients were divided into two groups, 60 each. Group A was managed expectantly for 24 hours while group B was induced with prostaglandin E2 vaginal passary or oxytoxin. Patients in both groups were monitored for signs and symptoms of chorioamnionitis. Fetal monitoring was done with fetoscope and CTG. Both the groups were observed for fetal distress, mode of delivery, postnatal complications like postpartum pyrexia, endometritis and for hospital stay. Neonatal outcome was assessed in terms of admission to Intensive care unit for > 24 hours and clinical signs of sepsis.  

Results: In immediate induction group, 44(77.3%) patients delivered vaginally, 10(16.6%) had caesarian section and 6(10%) had instrumental vaginal delivery as compared to 40 (66.6%), 12(20%) and 8(13.3%) respectively in the expectant management group. Postpartum pyrexia was noted in 8(13.3%) in the immediate induction group as compared to 10(30%) in the other group.  No significant difference was seen in fetal distress and neonatal infection rates between both the groups.

Conclusion: Immediate induction after term PROM is a safe and effective option with no adverse maternal and neonatal outcome when compared with expectant management. Immediate induction did not appear to increase cesarean section and instrumental vaginal delivery rates and was associated with decreased post natal pyrexia and conferred the benefit of reduced financial burden on patient as well as hospital by reducing the hospital stay. Key Words: Expectant Management, Pre-Labour Rupture, Membranes at Term

Citation of article: Bashir K, Navid S, Awan AS. A Comparison of 24 Hours Expectant Management Versus Induction of Labour in Pre-Labour Rupture of Membranes at Term. Med Forum 2017;28(5):7-10.