Comparison of Fetomaternal Outcome between Early Planned Labor Induction and Expectant Management in Late Preterm Pre-Labor Rupture of Membrane (PPROM)
Fetomaternal Outcomes in Late Preterm PPROM: Induction vs Expectant Management
DOI:
https://doi.org/10.54393/pjhs.v6i11.3378Keywords:
Cesarean Section, Labor Induction, PPROM, Neonatal ICU Admission, Neonatal Respiratory Distress Syndrome, Premature Rupture of Membrane, Maternal ComorbiditiesAbstract
Late preterm pre-labor rupture of membranes (PPROM) remains a clinical dilemma, with conflicting evidence regarding early induction versus expectant management. Objectives: To compare maternal and neonatal outcomes between early planned labor induction and expectant management in women with late preterm PPROM. Methods: This prospective comparative observational cohort study was conducted at the Department of Obstetrics and Gynecology, Kharadar General Hospital. A total of 134 women with late preterm PPROM (34+0 to 36+6 weeks) were enrolled and managed with either early planned induction (Group A, n=67) or expectant management (Group B, n=67). Outcomes were analyzed using Chi-square and Mann–Whitney U tests, and multivariate logistic regression was applied to adjust for maternal risk factors, including BMI, diabetes, and hypertension. Results: Maternal infection [40.3% vs. 23.9%, p=0.042], cesarean delivery [55.2% vs. 37.3%, p=0.038], neonatal infection [53.7% vs. 35.8%, p=0.037], and neonatal intervention [41.8% vs. 23.9%, p=0.027] were significantly higher in the induction group. Multivariate analysis showed hypertension as a strong predictor of maternal infection (aOR 11.45, 95% CI: 1.5–85.6, p=0.018) and neonatal intervention (aOR 3.22, 95% CI: 2.1–17.1, p=0.017), while obesity and diabetes significantly predicted cesarean delivery and neonatal infection. Conclusions: Early induction in late preterm PPROM was associated with increased maternal and neonatal complications, particularly among women with comorbidities. Expectant management with close surveillance may be safer in stable patients, especially in populations with high rates of hypertension, diabetes, and obesity.
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