Mean Duration of Active Phase of Labour between Amniotomy [Artificial Rupture of Membranes (AROM)] and Spontaneous Rupture of Membranes (SRM) in Primigravida

Abstract

Background: Labor is “the presence of uterine contractions of sufficient frequency, duration, and intensity to cause demonstrable effacement and dilation of the cervix” whose evaluation of progress is restricted to episodes of rudimentary examination of cervix while prospectively pointing the onset of labor still remains a challenge. This randomized trial was done to ascertain the short duration of labor in primigravida in active phase labor. Objectives: To compare the mean duration of active phase of labour between amniotomy [artificial rupture of membranes (AROM)] and spontaneous rupture of membranes (SRM) in primigravida. Materials and methods: A total 120 patients who were admitted in Labour room of Department of Obstetrics & Gynaecology, Nishtar Hospital, Multan in this randomized controlled Trial. In group A patients, Amniotomy (also referred to as artificial rupture of membranes [AROM]) was performed by using Kocker’s forceps in a controlled manner under aseptic measures with prophylactic antibiotics cover. Color of liquor was noted. In group B, patients with spontaneous rupture of membranes (SRM) were included. In both groups, labor was followed by keeping record of fetal heart sounds and vaginal examination one hourly to see the progress of labor. Duration of labor was noted in every patient of both groups as per partogram.  All the data was entered and analyzed by using SPSS version 20.0. Results: Our study comprised of a total of 120 primigravida females in active phase of labor. Mean age of our study cases was 25.13 ± 2.61 years ranging 22- 31 years. Mean gestational age of our study cases was 38.41± 1.18 weeks (ranging 37 – 41 weeks). Mean body mass index (BMI) of our study cases was noted to be 23.89 ± 1.66 kg/m². Mean duration of active phase of labor in our study was noted to be 5.14 ± 0.83 hours. Mean duration of active phase of labor in group A was 4.61 ± 0.59 hours while that of in group B was 5.67 ± 0.70 hours (p= 0. 000). Conclusion: Artificial rupture of membrane is safe, reliable and cost effective modality when employed in primigravida. Our study results indicate that artificial rupture of membrane in active phase of labor in primigravida is associated with significant reduction in duration of labor which reduces fetomaternal morbidity and mortality. Artificial rupture of membrane can be effectively employed to decrease hospital costs which is not only beneficial to the suffering families but also a relief for hospital authorities as well as healthcare professionals.

Keywords: Primigravida, Spontaneous rupture, duration of labor, artificial rupture of membranes.