Comparison of induction of labor versus conservative management in premature rupture of membranes on fetal outcome

Abstract

Background & Objective: Premature rupture of the membranes (PROM) is defined as rupture of the membranes (amniotic sac) before the commencement of the labor and after 37 weeks gestation. Opinions differ whether to induce labor in these parturients or continue to manage conservatively. The purpose of this research was to compare the incidence of unfavorable fetal outcomes in cases of early rupture of the membranes and expectant treatment in the induction of labor.

Methodology: This randomized controlled trial was conducted at the Department of Obstetrics & Gynaecology, Lady Reading Hospital, Peshawar, from 1st August 2022 to 31st January 2023. A total of 610 pregnant women with PROM were included in the study. In total, 305 patients were in the expectant management group or Group A, while 305 patients were in induction of labor or Group B. After delivery, fetal outcomes (birth asphyxia, low Apgar score, and sepsis) were noted and compared in both groups.

Results: Birth Asphyxia was observed in 69 (22.6%) patients in Group A as compared to 44 (14.4%) patients in Group B (P = 0.009). A low Apgar Score was observed in 27 (8.9%) patients in Group A compared to 10 (3.3%) patients in Group B (P = 0.004). Sepsis was observed in 8 (2.6%) patients in Group A as compared to 1 (0.3%) patient in Group B (P = 0.019).

Conclusion: It is concluded that all patients presenting with premature rupture of membranes at term should be actively managed with induction of labor.

Keywords: Pregnancy; Premature rupture of membranes; Labor induction; Expectant management; Adverse fetal outcomes

Citation: Khan M, Khattak S. Comparison of induction of labor versus conservative management in premature rupture of membranes on fetal outcome. Anaesth. pain intensive care 2024;28(3):541−546; DOI: 10.35975/apic.v28i3.2470

Received: March 08, 2024; Reviewed: May 01, 2024; Accepted: May 05, 2024