Author(s): Hassan Morsi, Abdel-Megeed, Youstina A. Sabry*,Ahmed Gamal Abdelnasser
Background: Premature rupture of the membranes (PROM) at term is defined as membrane rupture happening at least an hour before the onset of uterine contractions at a gestational age of 37 weeks or more. It complicates 8% of pregnancies in some way. With this diagnosis, there is an elevated risk of chorioamnionitis due to the length of the PROM. Objective: Comparing the effects of intravenous oxytocin, oral misoprostol, and vaginal dinoprostone (a PGE2 analogue) administration for labour induction in women with term prelabor rupture of membranes on mother and neonatal outcomes. Methods: Pre-labor membrane rupture at term affected 120 pregnant women who participated in this randomised control clinical trial. For cervical ripening and labour induction, group A received a dose of misoprostol equal to one-fourth of a 100-mcg tablet (or roughly 25 mcg), group B received vaginal PG E2 dinoprostone (Dinoglandin 3 mg), and group C had low-dose oxytocin regimens. Results: Induction-active phase time and induction-delivery time were significantly lower in group A and group C compared with the group B (P<0.05) with no significant difference between group A and C. Cesarean delivery rate was 22.5% in group A and 32.5% in group B versus 12.5% in group C and this difference was not statistically significant. As regards the factors associated with induction failure, our study results revealed that parity is an independent risk factor for failure of induction while method of induction. Conclusion: When compared to PGE2, immediate induction with oxytocin or oral misoprostol had considerable advantages in terms of birth time, caesarean section risk, and maternal infection. In the case of PROM at term, no definite benefit for oral misoprostol over intravenous oxytocin has been shown in terms of the duration of the induction-active phase, the length of the induction, the risk of caesarean birth, the incidence of maternal infection, or the result for the newborn.