Bushra Nazeer, Samina Kausar, Robina Ali, Shazia Shaheen.
PROM; expectant vs active management.
Professional Med J Jan ;20(4):519-25.

INTRODUCTION: PROM is not uncommon in pregnancy. It occurs in 10% of term pregnancies. At term about 75% of women will go into labour within 24 hours of rupture of membranes. At term there are two options, either wait for spontaneous onset of labour or immediate induction to establish labour. For induction of labour different kinds of drugs are used according to Bishop score. If Bishop score is favorable (6), oxytocin can be used. It decreases the risk of chorioamnionitis and is more satisfying for mother. OBJECTIVE: To compare the immediate induction with expectant management in PROM at term with favorable cervix in terof frequency of caesarean section. MATERIALS & METHODS: This prospective randomized controlled trial was conducted in the department of obstetrics & gynaecology, Punjab Medical College and affiliated hospitals, Faisalabad from 1st June to 30th November 2010. One hundred and twenty pregnant ladies were randomly divided into two equal groups. Odd numbers were placed in group 1 who were given expectant management for 24 hours for spontaneous onset of labour. Even numbers were placed in group 2, who were started immediate induction with oxytocin infusion. RESULTS: In my study overall age was 25.64±2.98. In expectant group mean age was 25.18±3.21 and in induction group mean age was 26.10±2.69. The rate of c-section in immediate induction group was 8.3% while in expectant group it was 11.6%. In my study there was no significant difference regarding rate of c-section in both groups (p= 0.543). CONCLUSION: Both expectant & immediate inductions are common management options in women with PROM, but immediate induction was favorable approach for both mother and fetus. The later was more satisfying for mother and decreased risk of maternal and neonatal infection.

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