PRE-LABOUR RUPTURE OF MEMBRANES AT TERM;

COMPARISON OF EXPECTANT MANAGEMENT AND INDUCTION OF LABOUR USING MISOPROSTOL (PGE1)

Abstract

Objective: To compare maternal and perinatal outcome in cases of PROM at term, following induction with vaginal
misoprostol (PGE1) to shorten the duration of labour with those managed expectantly. Design: Quasi Experimental study. Setting: The
study was carried out in department of obstetrics and gynecology labour room unit-1, Bahawal Victoria Hospital, Bahawalpur.
Population: Term pregnancies (37-42 wks) with PROM and cephalic alive fetuses. Methods: Sixty patients with confirmed diagnosis of
PROM were randomized into two groups i.e, A&B. Group A comprising 30 patients were induced with tab. Misoprostol 25 ug at 6 hrly
interval max of four doses and group B was managed expectantly for 24 hrs followed by induction with intravenous oxytocin. Outcome
Measures: Total duration of labour, mode of delivery, maternal infection rates and, APGAR score at 1 and 5 min. Results: It was found that
both groups had similar characteristics, but the misoprostol group had a significantly shorter time interval from PROM to delivery (18.9 vs
27.5 hours) i.e total duration of labour. Caesarean section rates were 20% in the misoprostol group and 30.7% in the other. There were no
differences between them regarding fetal well being, complications during labour and delivery and neonatal or postpartum maternal
morbidity. Within 24 hours, 44% of women had delivered in the expectant group against 73.3% in the misoprostol group. Conclusion:
Immediate labour induction with misoprostol in cases of term PROM shortens the total duration of labour, and the time of maternal
hospitalization without any maternal and perinatal outcomes disadvantages.