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Published:
Mar 7, 2013Keywords:
PROM stimulation of labour oxytocin misoprostol.
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Pre-Labour Rupture of Membranes at Term: A Review of Management in a Health Care Institution
Abstract
Background: Pre-labour rupture of membranes (PROM) at term is often encountered in current obstetric practice. Its management is sometimes controversial.
Objectives: This was to determine the incidence, management modalities and pregnancy outcomes of cases of pre-labour rupture of membranes at term in Nnewi, Southeast Nigeria.
Methods: This was a retrospective review of cases of PROM at term in Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Nigeria over a 5-year period (January 2005 - December 2009). Their demographic and obstetrics records were extracted and the findings were analysed using SPSS version 15.0.
Results: During the study period, there were 3,513 deliveries and 86 cases of PROM at term, giving an incidence of 2.4%. Of the 86 cases, only 74 (86.0%) case files were available for analysis. The mean age and gestational age of the patients were 26.9±3.9 years and 38.8±1.7 weeks respectively.
Vaginal delivery was aimed at 60 (81.1%) patients, of which 18 (30.0%) and 7 (11.7%) patients had immediate stimulation of labour with oxytocin and intravaginal misoprostol respectively. Ten (16.7%) and 6 (10.0%) patients had delayed stimulation of labour with oxytocin and intravaginal misoprostol respectively. Nineteen (31.7%) patients had spontaneous labour within 12 hours of rupture of membrane. Only 3(5.0%) patients had failed stimulation of labour. Vaginal delivery success rate was 95.0% while 17 (23.0%) patients were delivered by caesarean section (CS). There was no significant difference in the 1 and 5-minutes
APGAR scores <7 of babies delivered following immediate compared with delayed stimulation of labour and following stimulation of labour compared with spontaneous onset of labour (p>0.05). The mean duration of hospital stay was 6.1±
1.3 days and 10.9 ± 1.7 days for patients that had vaginal delivery and CS respectively. There was no recorded maternal death but the perinatal mortality rate was 0.26 per 1000 deliveries.
Conclusion: The incidence of PROM at term was high in Nnewi. While stimulation of labour was safe and effective, the pregnancy outcomes did not significantly depend on the time and methods of stimulation of labour or route of delivery. Further study may be necessary to substantiate these findings.
Key Words: PROM, stimulation of labour, oxytocin,
misoprostol.
Afrimedic Journal 2010; 1(2): 10-14
Objectives: This was to determine the incidence, management modalities and pregnancy outcomes of cases of pre-labour rupture of membranes at term in Nnewi, Southeast Nigeria.
Methods: This was a retrospective review of cases of PROM at term in Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Nigeria over a 5-year period (January 2005 - December 2009). Their demographic and obstetrics records were extracted and the findings were analysed using SPSS version 15.0.
Results: During the study period, there were 3,513 deliveries and 86 cases of PROM at term, giving an incidence of 2.4%. Of the 86 cases, only 74 (86.0%) case files were available for analysis. The mean age and gestational age of the patients were 26.9±3.9 years and 38.8±1.7 weeks respectively.
Vaginal delivery was aimed at 60 (81.1%) patients, of which 18 (30.0%) and 7 (11.7%) patients had immediate stimulation of labour with oxytocin and intravaginal misoprostol respectively. Ten (16.7%) and 6 (10.0%) patients had delayed stimulation of labour with oxytocin and intravaginal misoprostol respectively. Nineteen (31.7%) patients had spontaneous labour within 12 hours of rupture of membrane. Only 3(5.0%) patients had failed stimulation of labour. Vaginal delivery success rate was 95.0% while 17 (23.0%) patients were delivered by caesarean section (CS). There was no significant difference in the 1 and 5-minutes
APGAR scores <7 of babies delivered following immediate compared with delayed stimulation of labour and following stimulation of labour compared with spontaneous onset of labour (p>0.05). The mean duration of hospital stay was 6.1±
1.3 days and 10.9 ± 1.7 days for patients that had vaginal delivery and CS respectively. There was no recorded maternal death but the perinatal mortality rate was 0.26 per 1000 deliveries.
Conclusion: The incidence of PROM at term was high in Nnewi. While stimulation of labour was safe and effective, the pregnancy outcomes did not significantly depend on the time and methods of stimulation of labour or route of delivery. Further study may be necessary to substantiate these findings.
Key Words: PROM, stimulation of labour, oxytocin,
misoprostol.
Afrimedic Journal 2010; 1(2): 10-14
