COMPARISON OF ACTIVE AND EXPECTANT MANAGEMENT FOR FETOMATENAL OUTCOME AMONG WOMEN PRESENTING WITH PREMATURE RUPTURE OF MEMBRANE AT TERM

  • Mohsana Saeed Zia
  • Manzoor Ali khan
  • Sheeba Arooj
  • Shafaq Haneef

Abstract

BACKGROUND: Even though preterm rupture of the membranes (PROM) is a frequent obstetric occurrence, there is no agreement protocol for its treatment. A dilemma then emerges as to whether such moms should be induced right away or wait for natural labour to begin, and, if so, how long they should be allowed to wait.

OBJECTIVE:  The objective of this study is to compare the feto-maternal outcome of active versus expectant management in women presenting with PROM at term in a tertiary care hospital. 

METHODS:  This was a randomized trial conducted at Department of Obstetrics and Gynecology, Azad Jammu and Kashmir Medical College, Muzaffarabad. A total of 130 (65 in each group) women presenting with PROM at term were included in the study. Sample selection was done with the help of a predefined inclusion and exclusion criteria.

RESULTS: Prom to admission interval was significantly higher for active management (Active: 6.26 vs. Expectant: 5.46, p-value=0.043) and lower for prom to delivery interval (Active: 13.49 vs. Expectant: 16.27, p-value=0.002). No significant difference was seen between fetal and maternal outcome in active management and expectant management group. i.e. C-section (Active:23.1% vs. Expectant:36.9%, p-value=0.140), APGAR score at 1 (Active: 9.2% vs. expectant: 13.8%, p-value=0.410) and 5 minutes (Active: 6.2% vs. expectant: 10.8%, p-value=0.344), fetal [Meconium (Active: 13.8% vs. Expectant: 18.5%), birth asphyxia (Active: 12.3% vs. Expectant: 16.9%) & hyperbilirubinemia (Active: 7.7% vs. Expectant: 12.3%)] and maternal outcome (p-value=0.142).

CONCLUSION: Results of this study demonstrate no significant difference for feto maternal outcome for active management and expectant management of women presenting with PROM at term. However, women in active management groups had shorter delivery interval and hospital stay as compared to women in expectant groups.    

KEY WORD: Feto-maternal Outcome, Active Management, Expectant Management, Premature Rupture of Membrane, Term   

Published
2022-04-24
Section
Original Articles