OUTCOME OF INDUCING WOMEN APPEARING AT TERM WITH PREMATURE RUPTURE OF MEMBRANES (PROM) SOONER (BEFORE 6 HOURS) VS LATER (AFTER 12 HOURS)
Main Article Content
Keywords
At term, Induction of labour, Maternal outcomes, Neonatal outcomes, Premature rupture of membrane
Abstract
Objectives: To compare the outcomes of inducing women who appear at term with premature rupture of membrane (PROM) sooner (before 6 hours) and later (after 12 hours).
Study design: Randomized controlled trial
Place and duration of study: Department of Obstetrics & Gynecology, MCH Unit II, Pakistan Institute of Medical Sciences, Islamabad from July 2023 to June 2024.
Methods: A total of 140 women aged 18-42 years, parity <5, presenting at gestational age >37 weeks and reported with PROM were enrolled in this study and divided in to 2 equal groups.
In group A, patients were given induction of labor immediately after presentation (within 6 hours) while in Group B patients were given induction of labor late (after 12 hours) by instillation of 3mg tablet PGE2 (dinoprostone) in the posterior fornix.
The comparison of outcomes between the 2 methods was done by applying chi-square test and independent t-test where p-value ≤0.05 was considered statistically significant.
Results: The Mean±SD of age in this study was 27.84±5.66 years. The results of the study outcomes show that there was significantly less PROM to delivery interval (13.96±5.83 Vs 24.40±7.59 respectively, p=0.00), significantly more spontaneous delivery (70% Vs 50% respectively, p= 0.04) in Group A compared to Group B. The results of neonatal outcomes show significantly better APGAR score at 1 min (7.16±1.07 Vs 6.84±0.68 respectively, p=0.04) as well as at 5 min (7.89±1.46 Vs 7.45±1.01 respectively, p=0.04) and thereby significantly less number of neonates to be admitted in NICU (25.7% Vs 51.43% respectively, p=0.03) in Group A compared to group B.
Conclusion: For women presenting at term with PROM, sooner inductions are more effective than later inductions by providing better maternal and neonatal outcomes.
References
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Dr Sana Ghaffar Bajwa
Post Graduate Resident Gynae/Obs, MCH Unit 2; PIMS Islamabad
Dr Hina Mushtaq
Post Graduate Resident Gynae/Obs, MCH Unit 2; PIMS Islamabad
Dr Nida Arif
Post Graduate Resident Gynae/Obs, MCH Unit 2; PIMS Islamabad
Dr Sobia Haneef
Post Graduate Resident Pediatrics Medicine, Children Hospital; PIMS Islamabad
Dr Adnan Mushtaq
Assistant Consultant Nephrology, Quaid-E-Azam International Hospital, Islamabad
Dr Sabah Talib Shah
PGR Gynae and Obstetrics, Mardan Medical Complex, Mardan