Taiwanese Journal of Obstetrics and Gynecology
Volume 47, Issue 2 , Pages 192-196, June 2008

Pre-labor Rupture of Membranes at Term in Patients with an Unfavorable Cervix: Active versus Conservative Management

  • Aqueela Ayaz

      Affiliations

    • Hera General Hospital, Makkah, Saudi Arabia
    • ,
  • Shazia Saeed

      Affiliations

    • Bahawal Victoria Hospital, Bahawalpur, Pakistan
    • ,
  • Mian Usman Farooq

      Affiliations

    • Al-Noor Specialist Hospital, Makkah, Saudi Arabia
    • Corresponding Author InformationCorrespondence to: Dr Mian Usman Farooq, Health Research Centre, Al-Noor Specialist Hospital, P.O. Box 6251, Holy Makkah, Saudi Arabia
    • ,
  • Fayaz Ahmad

      Affiliations

    • Bahawal Victoria Hospital, Bahawalpur, Pakistan
    • ,
  • Luqman Ali Bahoo

      Affiliations

    • Bahawal Victoria Hospital, Bahawalpur, Pakistan
    • ,
  • Iftikhar Ahmad

      Affiliations

    • Al-Noor Specialist Hospital, Makkah, Saudi Arabia

Accepted 23 January 2008.

Article Outline

Summary 

Objective

To compare the safety and efficacy of conservative management of pre-labor rupture of membranes (PROM) at term in patients with an unfavorable cervix, with active treatment using oral misoprostol.

Materials and Methods

This quasi-experimental study was conducted between June 1, 2004 and November 30, 2004 at Bahawal Victoria Hospital, Bahawalpur, Pakistan. Eighty-four multigravid women (parity, < 5) at ≥37 weeks' gestation and with unfavorable cervices were divided equally between group S (study) and group C (conservative). Group S was given 50 μg of oral misoprostol every 4 hours for a maximum of four doses, while group C was managed conservatively. The intervals between PROM and significant uterine contractions and delivery, the mode of delivery, and maternal and fetal/neonatal complications were the main outcome measures.

Results

The intervals between PROM and the onset of uterine contractions and delivery were lower in group S than group C (9.6 vs. 14.8 hours; p< 0.001) and (11.6 vs. 17 hours; p < 0.001), respectively. Fewer women delivered abdominally within 24 hours of PROM in group S than in group C (5% vs. 24%; p < 0.05). Induction failure in group S was less than conservative management failure in group C (10% vs. 60%; p < 0.001). The maternal complication rate was less in group S than in group C (7% vs. 14%;p > 0.05), but the fetal/neonatal complication rate was similar in both groups (5%).

Conclusion

Oral misoprostol (50 μg) is safe and effective for cervical ripening and labor induction in patients with PROM and an unfavorable cervix. [Taiwan J Obstet Cynecol 2008;47(2):1 92-1 96]

Key Words:  induction , labor , misoprostol , PROM

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PII: S1028-4559(08)60079-0

doi:10.1016/S1028-4559(08)60079-0

Taiwanese Journal of Obstetrics and Gynecology
Volume 47, Issue 2 , Pages 192-196, June 2008

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