A Clinical Study on Expectant Management versus Induction of Labour in term Premature Rupture of Membranes (PROM)

Premature or Prelabour Rupture Of Membranes is classically defined as the rupture of integrity of the fetal membranes before the onset of labour and resulting in leakage of amniotic fluid [1-4]. Pre-labour rupture of membranes without spontaneous uterine contractions complicate approximately 10 % of all pregnancies, out of which 80 % occurs at term [5]. The management of PROM at term remains a matter of great debate till date. While induction of labour has resulted in decreased incidence of maternal & fetal sepsis, but it is also associated with a higher incidence of caesarean section rate due to fetal distress and uterine hyperstimulation. Kappa et al. [6] in their study, reported a higher incidence of operative deliveries in term pregnancies with ruptured membranes managed with labour stimulations compared with those who were managed expectantly [6]. Approximately 65-75 % of term PROM patients are followed by spontaneous onset of labour within 24 hours [7]. ProstaglandinsPGE2 & PGE1 have been used for cervical ripening and myometrial stimulation in unfavorable cervices with low Bishop’s preinduction score. It is seen that in patients who had expectant management, with prolonged hospitalization without active intervention with uncertain fetal and neonatal prognosis, many a times leads to maternal psychological sequalae [8].