Induction Of Labour Versus Expectant Management For Prelabour Rupture Of Membranes At Term: A Comparative Study At Maternity And Children Hospital, Najran, Saudi Arabia

Abstract

Background: Prelabour rupture of membranes (PROM) at term remains a significant obstetric challenge with implications for both maternal and neonatal outcomes. While expectant management supports spontaneous vaginal delivery, it is associated with increased risks of chorioamnionitis and neonatal sepsis. Conversely, induction of labour reduces infection risk and expedites delivery but may raise the likelihood of caesarean section. A balanced understanding of each approach is critical to guide clinical decision-making.

Aim: To compare maternal and neonatal outcomes in term PROM cases managed expectantly versus those undergoing labour induction. The study seeks to contribute evidence-based recommendations for PROM management in tertiary care settings.

Methods: A retrospective cross-sectional study was conducted at Maternity and Children Hospital, Najran, Saudi Arabia, over 14 months (January 2024 – February 2025). A total of 400 women with term PROM were reviewed: 320 received expectant management, while 80 underwent labour induction. Data were extracted from medical records and analysed using SPSS, employing chi-square tests and logistic regression to examine differences in clinical outcomes.

Results: Expectant management resulted in higher vaginal delivery rates (83% vs. 70%, p<0.05) but was associated with increased rates of chorioamnionitis (14% vs. 9%) and neonatal sepsis (12% vs. 7%). Induction significantly reduced delivery duration (18 ± 6 vs. 48 ± 16 hours) and NICU admissions (6% vs. 16%) but had a higher caesarean rate (30% vs. 17%).

Conclusion: The findings highlight the clinical trade-offs in PROM management. Personalised decisions based on maternal and foetal risk profiles remain essential to optimise outcomes.