COMPARISON OF ACTIVE VS EXPECTANT MANAGEMENT OF PRELABOR PREMATURE RUPTURE OF MEMBRANES BETWEEN 34-37 WKS OF GESTATION MATERNAL AND FETAL OUTCOME

Objectives: To compare induction of labor, in prelabor preterm rupture of membranes between 34 and 37 weeks of
gestation, with expectant management in terms of NICU admission, chorioamnionitis and mode of delivery.
Study Design: Randomized controlled trial
Place and Duration of Study: Department of obstetrics and gynaecology, Hayatabad medical complex Peshawar
from January 2014-August 2014.
Methodology: A total of 384 gravid women at > 34weeks 0 days and <36 weeks 6 days of gestation with PPPOM
were included in the study and divided into two groups of 192 each. Participants were randomly allocated by lottery
method in a 1:1 ratio to induction of labor(IOL) or expectant management(EX).
Results: Outcome measures included mode of delivery, cesarean section rate, hyperbilirubinemia, NICU admission
and chorioamnionitis. A total of 50(13%) patients underwent c/section. Out of these 33 were from actively managed
group and 13 were from conservative group. Hyperbilirubinemia was seen in 58(30.3%) of active and 32(16.6%) of
expectant group. Chorioamnionitis occurred more often in expectant group 8(4.1%) and maternal hospital stay was
also prolonged in this group. No serious adverse events were reported.
Conclusion: Aggressive management of preterm premature rupture of membranes at > 34 weeks of gestation by
induction of labor is safe and avoids maternal – neonatal infectious complications.
Key Words: Preterm premature rupture of membranes, induction, chorioamnionitis.