Maternal and Fetal Outcome of Prelabor Rupture of Membranes at Term. Prom) - a trial of 24 hours of expectant management.

Abstract

Objective: To find out the maternal and fetal outcome of 24 hours of expectant management. Design: Prospective descriptive study. Settings: Labor room of obstetrics and Gynae unit I, services hospital Lahore. Subjects: Participants were 100 women presenting with prelabor rupture of membranes at term. 50 nullipara and 50 multipara with cephalic presentation and no contraindication to vaginal delivery. Methods: All the participants of the study group were subjected to conservative management for 24 hours under antibiotic cover of Inj. cefataxime followed by induction if labor did not start spontaneously in 24 hours or if signs of chorioamnionitis developed at any stage. Data was collected on a Performa, which was then entered on database IV and analyzed in percentages on spss statistical package. Results: The magnitude of PROM in Gynae unit I services hospital in the year 2002 was 7.008%. 84% patients went into spontaneous labor, 2% patients developed signs of chorioamnionitis, and 14% patient did not enter into spontaneous labor after 24 hours of PROM. 94% patients with PROM delivered vaginally total of 6 c/s were carried out, 2% c/s due to fetal distress, 2% for failed induction and 2% for fetal distress after induction. Postnatal complications included chorioamnionitis 2%, PPH 7%, puerperal pyrexia 4%, wound infection 3%, and DVT in 1% patients. Neonatal complications included admission to ICU in 8% babies and neonatal infection in 1%. There was no fetal mortality. Conclusion: Conservative approach did not negatively affect fetal maternal outcomes.