A COMPARATIVE STUDY ON EARLY VERSUS DELAYED INDUCTION OF LABOR IN PATIENTS WITH PRELABOR RUPTURE OF MEMBRANES AT TERM

Abstract

Objective: To compare the maternal outcomes in terms of mode of delivery (vaginal vs. cesarean) and duration of labor in patients with prelabor rupture of membranes (PROM) at term. randomized to early versus delayed induction of labor.

Study design: A randomized controlled trial

Place & duration of the study: Obstetrics & Gynecology Department of Arif Memorial Teaching Hospital, Lahore from May 1 2025 to September 2025.

Methods: The study included 88 term PROM patients equally divided into early and delayed induction groups. Labor was induced using 0.5 mg PGE₂ gel. Maternal outcomes such as mode of delivery and duration of labor were compared between two groups.

Results: The maternal age was comparable between the two groups (30.75 ± 3.58 years in early induction vs. 31.53 ± 4.06 years; p = 0.194). The duration of labor was significantly shorter in the early induction group (13.02 ± 2.26 hours) than in the delayed group (19.65 ± 2.01 hours; p < 0.001). Normal vaginal delivery was more frequent with early induction (39.2% vs. 18.6%), while cesarean section rates were higher in the delayed induction group (31.4% vs. 10.8%; p < 0.001). When the data were stratified by age, gestational age, BMI, and parity, the same pattern was observed, all with p-values < 0.05 in each subgroup.

Conclusion: The current study contributes valuable data supporting early induction as a safe and effective approach for managing term PROM and provides a foundation for developing standardized clinical guidelines in similar settings.