Comparison of Conventional Treatment of Prom (Pre Labor Rupture of Membranes) with Active Treatment in Term Patients

Abstract

Objectives: To compare outcome of conventional treatment of Pre labor rupture of membranes (PROM) with active treatment in term patients.

Place and Duration: This study was Conducted in Family Medics Infertility and Maternity Centre Karachi from March 2022 till June 2022.

Materials & Methods: We conducted a randomized control trial on 74 registered patients who presented to the labor room with term pregnancy and with the ruptured membranes at thirty-seven weeks or more gestation verified from the last normal menstrual period or a dating scan. Two groups were randomized as either spontaneous labor or active management by Prostin.37 patients presented in Prelabour rupture of membranes were examined as per departmental policy and left for spontaneous labor and 37 women were actively managed by inserting Prostin in the posterior fornix.

Main Outcomes Measured: The outcome of interest was intervention vs .non intervention regarding timespan between PROM and initiation of labour in respective groups. Secondary outcome included patients who did not respond to either conventional measures or active treatment and required caesarian section.

Results: The time duration between rupture membrane and initiation of labour was less in intervention group as compared to conservative group (6.40hrs vs. 5.03hrs).The rates with respect to normal delivery or caesarian section were same in test and control groups (27 pts. vs. 25 pts.). There was no statistically significant difference regarding complication in both the arms in study. (P-value=0.967)

Conclusion: The results of our study showed that there are no differences in outcomes of conservative management of PROM with that of active management. However, patients managed actively in intervention group delivered earlier as matched with patients with spontaneous management.

Keywords: Term pregnancy, PROM, Spontaneous vaginal delivery, Emergency Cesarean section. The Registration number of the study specified by the university is JSMU/IRB/2022/-601.