Fetomaternal Outcome with Active versus Expectant Management of Pre Labour Rupture of Membranes at Term; A randomized controlled trial.

Abstract

Objective: To compare fetomaternal outcome with immediate/active versus expectant management in pregnancies complicated with pre labour rupture of membranes at term.

Methodology: A randomized prospective controlled trial conducted in Obstertics & Gynaecology department of Benazir Bhutto Hospital, Rawalpindi from 1st July 2022 till 31st December 2022. All women presenting with PROM at term and fulfilling the inclusion criteria were recruited and randomized equally to Group-A and Group-B for Active versus Expectant management. The latency period for onset of labour, mode of delivery, maternal and fetal complications were compared in two groups.

Results: During study period, 190 women were recruited. The mean maternal age was 26.16 years. Out of total, 45% were primigravidas, 40% multigravidas and 15% were grand multiparas. Mode of delivery was comparable in both groups (p-value >0.05). The latency period was significantly prolonged (>24 hours) in 57.9 % of the patients with expectant management (p-value <0.05). The rate of PPH and chorioamnionitis was higher in expectant group while neonatal complications were comparable in both groups.

Conclusion: The active management of PROM is the preferred management option due to a shorter latency period, lesser maternal complications, without any significant increase in the rate of operative delivery.