Immediate Induction Versus Expectant Management in Term Premature Rupture of Membranes: A Longitudinal Analysis of Maternal and Neonatal Outcomes.

Background and aim Premature rupture of membrane (PROM) is an obstetric problem that refers to the rupture of the membrane integrity of the fetus before delivery. PROM has considerable adverse impacts on both maternal and neonatal outcomes. This study aimed to compare the effectiveness of the two major management strategies for PROM, expectant management and labor induction, by evaluating outcomes between the two groups. This study was conducted due to the lack of previous research comparing these approaches in the context of PROM in Bahrain. Methods A prospective longitudinal, non-randomized, comparative interventional study was conducted at the Obstetrics and Gynecology Department of King Hamad University Hospital from July 2021 to December 2022 on pregnant women with a gestational age of 37 weeks or more with confirmed membrane rupture. Demographics, medical, surgical, and obstetric histories were recorded. The study included two baseline-matched groups; Group I involved 86 women who underwent expectant management for 24 hours followed by oxytocin augmentation, whereas Group II included 58 women who underwent immediate induction of labour with prostaglandin. Results There were significant differences between the two groups regarding mean age (p = 0.034), parity (p = 0.002), admission to the neonatal intensive care unit (p = 0.025), mode of delivery (p = 0.040), Bishop score (p = 0.003), and induction interval to active labour and delivery (p < 0.0001). Conclusion The comparison between immediate induction with prostaglandin and expectant management followed by oxytocin augmentation revealed that there was no definite optimum management approach, as each method has its own benefits and complications. The determination of the best approach can be based on the condition of pregnant women.