FETOMATERNAL OUTCOME IN PATIENTS WITH PRELABOUR RUPTURE OF MEMBRANE IN CIVIL HOSPITAL KARACHI

Objectives: To compare the fetal and maternal outcomes in interventional (induction of labor) verses expectant management of prelabour rupture of membranes at term.Materials and Methods: This Randomized control trial was conducted from December 2014 to June 2015 in obstetrics and gynecology department civil hospital Karachi.. A total of 284 patients were recruited via non probability consecutive sampling technique. Women were randomized into group A (intervention group) & Group B (expectant group). Randomization was blinded and was done by opening of the closed envelopes. Women in group A induced with tablet prostaglandin E2 placed in posterior vaginal fornix (2 doses 6 hours apart) group B expectant group patient monitored for 24 hours for spontaneous initiation of labour, under strict fetomaternal monitoring. (Fetal heart rate (<160bmp) was monitored one hourly and maternal vital signs (pulse <100bmp) four hourly, If patients in group B did not go into labor till 24 hours, they were induced. Labour management was according to normal labour protocols. The management outcomes were measured and recorded on approved Performa.Results: Average ages was 27.6 ± 6.1 in interventional group and 27.7 + 6.2 years in expectant group with mean duration of labor was 9.4 ± 4.9 and 13.6 ± 5.7 respectively and mean duration of PROM was 3.1 ± 1.9 and 2.9 ± 2.0. When APGAR score were compared, 9(6.3%) had APGAR score < 7 in interventional group and 13(9%) had APGAR score < 7 in expectant group, showed no significant difference but when Chorioamnionitis were compared, 8(5.9%) had positive in interventional group and 28(19.7%) had positive in expectant group and showed significant difference.Conclusion: This trial concluded that the interventional management leads to reduced Chorioamnionitis as compared to expectant management but did not find the differences in the rates of fetal outcome.