ABSTRACT
To compare the management outcome of induction of labor with expectant management in patients with term pre labor mpture of membranes [PROM]. Randomized controlled trial. This study was conducted in the department of Obstetrics and Gynaecology; Combined Military Hospital Rawalpindi from 25[th] July 2010 to 25[th] January 2012. A total of 384 patients were selected for this study, which were divided into two groups by lottery methoid. Patients in group A were induced with tablet prostaglandin E2 and group B patients were managed expectantly for 24 hours. The outcome of mothers and neonates was recorded on a pre-designed proforma, The mean duration between PROM to onset of active labor in group A was significantly less [8.4 +/- 2.3 hours] as compared to group B in which it was [9.6 +/- 2.1 hours] [p = 0.000]. The mean duration between PROM to delivery in group A was significantly less in group A [17.4 +/- 20] versus group B [22.2 +/- 2.0 hours] [p = 0.0000]. The spontaneous vaginal delivery [SVD] rate was considerably higher [p=0.056] in group A in which 161 [83.8%] patients delivered by SVD and 31 [16.1%] patients by LSCS. In group B, 146 [76.0%] patients delivered by SVD and 46 [23.9%] patients by LSCS. In group A, 8 [4.1%] patients developed chorioamnionitis and 13 [6.7%] patients in group B [p = 0.262]. In group A there were 178 [92.7%] neonates with APGAR score of > 5 at 1 minute in contrast to 173 [90.1%] in group B with [p = 0.363]. Similarly in group A at 5 minutes, there were 178 [92.7%] neonates with APGAR score of >7 and 173 [90.1%] in group B [p = 0.460]. There were 9 [4.6%] cases of neonatal sepsis in group A, in comparison with 12 [6.2%] patients in group B [p = 0.501]. The mean duration of labor in induced patients was less as compared to patients with expectant management