ROLE OF PROSTAGLANDIN E2 FOR INDUCTION OF LABOR IN PATIENTS WITH PREMATURE RUPTURE OF MEMBRANES AT TERM.

Abstract

Background; As the time between the rupture of the membranes and the onset of labor increases, so may the risk of maternal and fetal infection so this study was conducted to ascertain the role of prostaglandin E2 for induction of labor in patients with PROM at term.  Material and Methods; All the study cases (n = 161) presenting with premature rupture of membranes (PROM) having singleton were taken from Department of Gynecology and Obstetrics, Nishtar Hospital Multan in this descriptive case series. Pregnant women were examined in lithotomy position, leakage of fluid was inspected by sterile speculum.  Three mg of Prostaglandin E₂ was kept in posterior fornix and women were kept in left lateral position for 30 minutes. If the uterine activity does not start and Bishop score remains unchanged (≤6), same dose was repeated after 6 hours. Data was analyzed by using SPSS Version 20. Results; Mean age of our study cases was 28.74 ± 5.03 years (with minimum age was 21 years while maximum age was 39 years). Our study results have indicated that majority of our study cases i.e. 112 (69.6%) were aged 20 – 30 years of age. Of these 161 study cases, 70 (43.5%) were from rural areas while 91 (56.5%) were from urban areas. Mean parity of our study 3.17 ± 0.81 and most of the study cases i.e. 105 (65.2%) had parity up to 3. Mean gravidity was 4.35 ± 0.81 and most of the study cases i.e. 91 (56.5%) had gravidity up to 4. Mean body mass index (BMI) was noted to be 24.21 ± 3.08 kg/m² and obesity was noted in 28 (17.4%) of our study cases. Mean duration of hospitalization before delivery was noted to be 14.15 ± 4.67 hours while time taken for induction of labor was 4.24 ± 1.36 hours and mean gestational age was noted to be 39.43 ± 1.17 weeks. Cesarean section was noted in 31 (19.3%) of our study cases while 130 (80.7 %) underwent vaginal deliveries and poor APGAR score was noted in 11 (6.8%). Conclusion; Our study results support the use of prostaglandin E2 for induction of labor in women with premature rupture of membranes at term as it was safe, reliable and effective mode of treatment. No major side effects were noted in our study. Mode of delivery and poor APGAR score were significantly associated with parity, gravidity, obesity and prolonged duration of hospitalization.

Keywords; Premature rupture of membrane, term, prostaglandins