Fetomaternal Outcomes of Early and Delayed Induction of Labour in Term Pregnancy after Premature Rupture of Membranes

Fatima Bibi; Fouzia Gul; Nabeela Rauf; Momina Shoaib; Nafeesa; Nabeel Shahriyar

doi:10.70749/ijbr.v3i7.2447

Authors

Fatima Bibi Liaqat Memorial Hospital, Kohat, Pakistan
Fouzia Gul Liaqat Memorial Hospital, Kohat, Pakistan
Nabeela Rauf Liaqat Memorial Hospital, Kohat, Pakistan
Momina Shoaib Liaqat Memorial Hospital, Kohat, Pakistan
Nafeesa Liaqat Memorial Hospital, Kohat, Pakistan
Nabeel Shahriyar Liaqat Memorial Hospital, Kohat, Pakistan

DOI:

https://doi.org/10.70749/ijbr.v3i7.2447

Keywords:

Apgar score, Chorioamnionitis, Induced labor, Maternal outcomes, Neonatal outcomes, Premature rupture of membranes, Term pregnancy

Abstract

Background: Premature rupture of membranes refers to the spontaneous breaking down of the fetal membranes prior to labor initiation and affects about ten percent of term pregnancies. It elevates the risk of infection among mothers and neonatal infection, umbilical compression, and fetal distress. Management of early labor induction versus delayed induction after membrane rupture remains clinically contentious since delayed treatment poses infection risk, while early treatment increases the risk of operative delivery. Objective: To compare fetomaternal outcomes between early and delayed induction of labor in term pregnancies following premature rupture of membranes. Study Design: Comparative cross-sectional study. Duration and Place of Study: This study was conducted from March 2025 to May 2025 at the Department of Obstetrics and Gynaecology, Liaqat Memorial Hospital, Kohat. Methodology: A total of 316 women with singleton term pregnancies and confirmed premature rupture of membranes were enrolled through consecutive non-probability sampling. Participants were divided into two groups: early induction (within 12 hours of rupture) and delayed induction (after 12 hours). Maternal outcomes assessed included chorioamnionitis, placental abruption, postpartum hemorrhage, and failed induction, while neonatal outcomes included Apgar score and neonatal sepsis. Results: Early induction resulted in higher vaginal delivery rates (78.5% vs. 69.0%) and significantly lower chorioamnionitis (3.8% vs. 17.7%, p<0.001) and failed induction (4.4% vs. 10.8%, p=0.034). Postpartum hemorrhage and placental abruption were less frequent in the early induction group, and low Apgar scores were also reduced (2.5% vs. 7.6%). Conclusion: Early induction of labor following premature rupture of membranes at term significantly improves maternal and neonatal outcomes, reducing infectious complications and delivery failures compared to delayed induction.

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