Managing Premature rupture of membranes at term

Spontaneous membranes rupture after 37 wks of the gestations and before the onset of the regular painful uterine contractions is known as the Premature rupture of the membranes at term. It accounts for about ten percent of cases and observes expectant or active management. 

A recent study investigated the effectiveness of early labor induction and assessed maternal and fetal outcomes in term pregnancy with cervical PGE2 versus expectant management. 

The study included 144 individuals and divided them into two groups – Group A containing subjects with expectant management and Group B with subjects induced with intracervical PGE2. The study then compared their outcome. 

It found-

• In group A, 70.83% of cases experienced spontaneous labor within 24 hrs, and in those with induction, 56.94% were successful. 
• Of the spontaneously delivered, 65.28% were primi, with 58.33% having a favorable Bishop Score. 
• Of those with induction, 73.61% were primi, with 56.94% having a favorable Bishop Score. 

Thus, early labor induction in cases of PROM at term with PGE-2 GEL causes low labor latency and increases operative intervention. The expectant line shows greater maternal and neonatal morbidity.

Burande A, Dube A. Premature rupture of membranes at term: Early induction versus expectant management. Indian Journal of Obstetrics and Gynecology Research, January-March, 2018;5(1):1-4. DOI: 10.18231/2394-2754.2018.0001