This study was undertaken to compare two types of management of rupture of the membranes between 36 and 41 weeks of pregnancy.
Two hundred and fifteen patients with premature rupture of the membranes(PROM) were divided into two groups of management policies over 4 years period.
One hundred and two patients (from August 1, 1988 to September 31, 1990) were placed on the induction of labor using PGE2 suppository, within 6 to 12 hours after rupture of the membranes irrespective of the condition of the cervix, were
designated
active management group. One hundred and thirteen patients (from May 1, 1987 to July 31, 1988), managed expectantly, were designated selective conservative management group. Labor was induced, in the expectantly managed group, only for favorable
cervix
(Bishop score >7), poor biophysical profile (<6), and decreased amniotic fluid (vertical pocket <1 cm). The parturients with any medical or obstetrical condition warranting immediate intervention were exclude from the study.
Duration of the labor was more prolonged and abnormal labor patterns were more frequent in active management group than in selective conservative management group, though statistically insignificant. Maternal febrile morbidity, neonatal death,
and
neonatal infection were not increased in selective conservative management group compared to active management group.
We could conclude that, active management of labor, early use of PGE2, was associated with significant reduction of the mean duration of time from PROM to delivery without a significant increase in febrile morbidity or cesarean section rate. The
active
management had no role in reducing the maternal-fetal morbidity, compared with conservative management, and it was associated with a slight increase in cesarean section rate and abnormal labor patterns over the conservative management.
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