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DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20180412
Original Research Article
Department of Obstetrics and Gynecology, KPC Medical College and Hospital, Kolkata, West Bengal, India
*Correspondence:
Dr. Arnab Mondal,
E-mail: arnabbon@gmail.com
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ABSTRACT
International Journal of Reproduction, Contraception, Obstetrics and Gynecology Volume 7 · Issue 3 Page 856
Mondal A et al. Int J Reprod Contracept Obstet Gynecol. 2018 Mar;7(3):855-859
Table 5: Use of oxytocin in the study cases and control difference in occurrence of cord prolapse between the
group. study and control groups is not statistically significant.
Oxytocin used for induction Oxytocin Table 8: Incidence of cord prolapse in study and
and augmentation of labor not used control group.
56 (20 induction+36
Study 31
augmentation) Cord prolapse No cord prolapse
Control 11 (5 induction+6 augmentation) 89 Study 2 98
Control 0 100
From Table 5, we found that the use of oxytocin to
induce and augment labor was more in PROM cases than DISCUSSION
the control series. A Chi Square Test done on Table VI
shows that for the obtained Chi Square value (57.64) and Latent period
df 1, the p value is <0.05. So, the increase in use of
oxytocin for induction and augmentation of labor in In this series, majority of PROM cases went into
PROM cases compared to controls is found to be spontaneous labor (67%). This simulates the findings of
statistically highly significant. Of the 56 PROM patients Lebherz TB et al-61%, Sacks et al-52.7%, Conway DI-
where oxytocin was used, 48 delivered vaginally and 8 by 79%, Raut MD et al-82.4% and Cammu H et al-80-
L.S.C.S. Of the 11 controls where oxytocin was used, 8 90%.2-6 This study shows that majority of patients with
delivered vaginally and 3 by L.S.C.S. PROM have latent period <24 hrs (Table 1).
Table 6: Duration of first stage of labor in study cases Latent period and gravida status in PROM
and control group.
This study shows that majority of patients with PROM,
Duration of 1st stage Duration of 1st both primi and multigravida have latent period <24 hrs
<12 hrs stage >12 hrs (Table 2).
67 (77%) 20 (23%)
Study
(6 primi+61 multi) (11 primi+9 multi) Latent period and gestational age
67 (67%) 33 (33%)
Control
(2 primi+65 multi) (15 primi+18 multi) It is observed that latent period is inversely related to the
gestational age when PROM has occurred (statistically
It appears from Table 6 that the duration of 1st stage of significant). This finding is consistent with that of
labor is shortened with PROM. A Chi Square Test done Donnelly JF (1957), who reported longer latent period
on Table IV shows that for the obtained Chi Square value with shorter gestational age (Table 3).7
(2.3) and df 1, the p value is >0.05. So, the apparent
shortening of duration of 1st stage of labor with PROM Modes of deliveries of PROM cases
compared to control is not statistically significant.
In the present study, in the PROM group, vaginal
Table 7: Incidence of intrapartum fetal distress in deliveries were noted in 71% cases (Table 4). Sanyal MK
study and control series. et al reported 87% vaginal deliveries in PROM cases.8 In
this study, forceps deliveries were undertaken in 14% of
Intrapartum fetal No Fetal PROM cases and 7% of controls (mostly in fetal distress
distress distress in second stage of labor, non-descent of presenting part
Study 7 93 and/or maternal distress in second stage of labor, or
Control 4 96 prolonged second stage of labor). The caesarean section
rates reported by different authors in PROM patients are
Table 7 shows that intrapartum fetal distress (manifested as follows: Schreiber J et al-24%, Spinnato JA-15.4%,
by fetal bradycardia, meconium stained liquor etc.) Egan et al-8% in primigravida, 2% in multigravida,
appears to be more in PROM cases than in the control Sanyal et al-3.5%, Chua S et al-14.9-19.1%, Shalev E et
group. A Chi Square Test done on Table 7 shows that for al-4.7-6.7%, Ladfors L et al-2-4%, Hannah ME et al-9.6-
the obtained Chi Square value (0.87) and df 1, the p value 10.9%.8-15 Caesarean section was undertaken in 15% of
is >0.05. So, the apparent increase in intrapartum fetal PROM cases in the present series, which is nearly
distress in PROM cases compared to controls is not consistent with the findings of Spinnato JA, Chua S et al
statistically significant. and Hannah ME et al.10,12,15 In the present study, the
incidence of caesarean section among PROM cases was
Table 8 shows only 2 cases of cord prolapse in study 1.5 times higher in primigravida than multigravida, which
group and no such cases in control group. A Chi Square corroborates with the findings of Egan et al (section rate
Test done on Table VIII shows that for the obtained Chi 4 times higher in primigravida).11 The incidence would
Square value (2.02) and df 1, the p value is >0.05. So, have approached the reported 4 times higher in
primigravida, but, it is only 1.5 times here because post
International Journal of Reproduction, Contraception, Obstetrics and Gynecology Volume 7 · Issue 3 Page 857
Mondal A et al. Int J Reprod Contracept Obstet Gynecol. 2018 Mar;7(3):855-859
International Journal of Reproduction, Contraception, Obstetrics and Gynecology Volume 7 · Issue 3 Page 858
Mondal A et al. Int J Reprod Contracept Obstet Gynecol. 2018 Mar;7(3):855-859
5. Raut MD, Dora H. PROM- A clinical and premature rupture of membranes in term
bacteriological study. J Obstet Gynaecol India. pregnancies. Obstet Gynecol. 1995 May;85(5 Pt
1988;38:554-62. 1):766-8.
6. Cammu H, Verlaenen H, Perde MP. Premature 14. Ladfors L, Mattson LA, Eriksson M, Fall O. A
rupture of membranes at term in nulliparous women: randomized trial of two expectant managements of
a hazard?. Obstet Gynecol. 1990 Oct;76(4):671-4. prelabor rupture of the membranes at 34 to 42 weeks.
7. Donnelly JF, Flowers CE, Creadick RM, Greenberg Br J Obstet Gynaecol. 1996 Aug;103(8):755-62.
BG, Wells HB. Parental, fetal, and environmental 15. Hannah ME, Ohlsson A, Farine D, Hewson SA,
factors in perinatal mortality. Am J Obstet Gynecol. Hodnett ED, Myhr TL et al. Induction of labor
1957 Dec;74(6):1245-56. compared with expectant management for prelabor
8. Sanyal MK, Mukherjee TN. Premature rupture of rupture of the membranes at term. TERM PROM
membranes an assessment from a rural medical Study Group. N Engl J Med. 1996 Apr
college of West Bengal. J Obstet Gynaecol India. 18;334(16):1005-10.
1990;40(5):623-8. 16. Calkins LA. Premature spontaneous rupture of the
9. Schreiber J, Benedetti T. Conservative management membranes. Am J Obstet Gynecol. 1952
of preterm premature rupture of the fetal membranes Oct;64(4):871-7.
in a low socioeconomic population. Am J Obstet 17. Theobald GW, Kelsey HA, Muirhead JMB. The
Gynecol. 1980 Jan;136(1):92-6. pitocin drip. J Obstet Gynaecol Br Emp. 1956
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12. Chua S, Arulkumaran S, Karup A, Anandakumar C,
Tay D, Ratnam SS. Does prostaglandin confer
significant advantage over oxytocin infusion for Cite this article as: Mondal A, Kanoongo S. A study
nulliparas with prelabor rupture of membranes at on management of premature rupture of membranes.
term? Obstet Gynecol. 1991 May;77:664-7. Int J Reprod Contracept Obstet Gynecol 2018;7:855-
13. Shalev E, Peleg D, Eliyahu S, Nahum Z. Comparison 9.
of 12-and 72-hour expectant management of
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