INDUCTION OF LABOUR VERSUS EXPECTANT MANAGEMENT FOR PREMATURE RUPTURE OF MEMBRANES AT TERM

Background :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 These cases are either managed conservatively or by immediate induction of labour.

Material and Methods :A prospective, randomized controlled study was carried out for a period of   two years from November 2008 to October 2010 at  Rural Medical College, Loni. One hundred pregnant women with term PROM were assigned randomly, each  in induction  and expectant group.

Results :.The mean  interval from induction to delivery was significantly shorter in the induction group as compared with expectant group . Incidence of maternal morbidity was comparable in both the groups Neonatal morbidity was higher in expectant group . Incidence of hyper stimulation were more with induction group  as compared to expectant  group. There was no maternal or perinatal mortality in any group. Intrapartum complications  and mode of delivery were similar in both groups

Conclusion: Immediate induction of labour in cases of PROM at term using oral misoprostol resulted in shorter induction delivery interval but  increased rate of operative intervention. Maternal morbidity was comparable with induction and expectant line of management. However, neonatal morbidity was higher in expectant group

Premature rupture of membranes; Induction of labour; Maternal morbidity; Neonatal morbidity; Misoprostol