Despite recent advances in management of pregnancies complicated with PPROM , yet can lead to significant risk for mother and neonate.Unfortunately there is insufficient evidence to guide appropriate management for cases between 34-36 weeks of pregnancy (whether to choose induction of labor or expectant management ).
Our objective was to compare maternal and perinatal outcomes between two management schemes for this group of pregnant women.
Material and Method :
In present study 60 cases of pregnant women , admitted for PPROM and complying with our inclusion and exclusion criteria were randomly allocated in one of the two groups :
Expectant management group ( control group - group one ) or induction of labor group (intervention group - group two). Labor was induced in women in the second group after admission for 24 hours and receiving corticosteroids . Women in the first group were expectantly managed till 36 weeks of pregnancy and received corticosteroids plus antibiotics for seven days. Labor was induced when they reached 36 weeks or if any sign of clinical chorioamnionitis or any other maternal or fetal indications were observed .
Finally ,mothers and newborns were followed till 40 days after delivery .
There were no statistically significant difference between the two group with regard to maternal age, gravidity , gestational age , birthweight , first minute APGAR score , five minute APGAR score, mode of delivery , RDS , hypoglycaemia , hyperbilirubinemia, clinical chorioamnionitis , puerperal complications .The length of NICU stay was the only outcome with a borderline statistical difference (P value : 0.051) .
In our study a policy of expectant management of pregnancies complicated by late PPROM in comparison to active management did not impose additional risk to either mother or newborn ( fetus ) and may be selected to prevent neonatal complications related to preterm birth.
Key words: Pre-term Pre-mature Rupture of Membranes (PPROM), rupture of membranes, induction of labor, maternal and fetal complications