Year: 2026
Type: article
Study designs: Randomized Controlled Trial, Clinical Trial
Abstract: Prelabor rupture of membranes (PROM) at term is a common obstetric condition associated with increased maternal and neonatal morbidity if delivery is delayed. The optimal timing of labor induction following PROM remains controversial because immediate induction may reduce the risk of infection but may also increase operative deliveries. This prospective study was conducted in the Department of Obstetrics and Gynaecology, JNMCH, AMU, Aligarh, between February 2012 and November 2013 to compare maternal and neonatal outcomes following immediate induction and delayed induction after expectant management in women with term PROM. A total of 100 women with singleton pregnancies beyond 37 weeks of gestation were randomly allocated into two equal groups. Group A underwent immediate induction using misoprostol or oxytocin according to Bishop score, whereas Group B received expectant management for 12 hours followed by induction if labor did not begin spontaneously. More women in the delayed induction group entered spontaneous labor (56%), thereby reducing the need for induction. Caesarean section rates were significantly lower in the delayed induction group for both nulliparous and multiparous women. Fetal distress occurred more frequently in the immediate induction group (12% vs. 4%), while no cases of clinical chorioamnionitis were observed in either group. Neonatal outcomes, including Apgar scores, NICU admission, feeding difficulties, and neonatal infection, were comparable between the two groups. The findings indicate that expectant management followed by delayed induction allows spontaneous labor in many women without increasing maternal or neonatal infectious morbidity and is associated with a lower rate of cesarean delivery compared with immediate induction in term PROM.
Authors: Fatima Usmani, Zehra Mohsin, Rana K Shewani
Language: English
Subfield: Obstetrics and Gynecology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W7202079991