Department of Obstetrics and Gynaecology, Enugu State University of Science and Technology (ESUT) Teaching Hospital, Parklane, Enugu, Nigeria.
Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Anambra State, Nigeria.
J Int Med Res. 2023 Aug;51(8):3000605231195451. doi: 10.1177/03000605231195451.
To compare the effects on feto-maternal outcomes of expectant versus active management for premature rupture of membranes (PROM) at term.
This was a prospective randomized (1:1) controlled study involving 86 pregnant-women who received either expectant management (n = 43) or active management with misoprostol (n = 43) for PROM at term. Primary outcome was route of delivery. Secondary outcomes were: PROM to presentation interval; latency period; PROM to delivery interval; recruitment to delivery interval; labour and delivery complications.
Baseline-characteristics were similar between groups. There was no significant difference between active and expectant groups in mean PROM to presentation/admission, or PROM to delivery. However, mean latency period (11.1 ± 7.3 hours vs 8.8 ± 5.5 hours) and mean recruitment to delivery intervals after PROM (14.7 ± 5.2 hours vs 11.8 ± 5.0 hours) were significantly shorter for the active group compared with the expectant group. Although the rate of caesarean section was less in expectant management group (21%) compared with the active management group (30%), the difference was not statistically significant. There were no significant differences between groups in delivery or perinatal complications.
Active and expectant management for PROM at term gave comparable outcomes in terms of methods of delivery and complications. However, active management significantly shortened the latency period and induction to delivery intervals compared with expectant management. Pan-African-trial-registry-(PACTR)-approval-number PACTR202206797734088.
比较足月胎膜早破（PROM）期待治疗与积极治疗对母婴结局的影响。
这是一项前瞻性随机（1:1）对照研究，纳入 86 例足月 PROM 孕妇，分别接受期待治疗（n=43）或米索前列醇积极治疗（n=43）。主要结局为分娩方式。次要结局为：PROM 至出现临产的时间间隔；潜伏期；PROM 至分娩的时间间隔；入院至分娩的时间间隔；分娩和产时并发症。
两组基线特征相似。积极治疗组与期待治疗组 PROM 至出现临产/入院的平均时间或 PROM 至分娩的平均时间无显著差异。然而，积极治疗组的潜伏期（11.1±7.3 小时比 8.8±5.5 小时）和 PROM 后入院至分娩的平均时间间隔（14.7±5.2 小时比 11.8±5.0 小时）明显短于期待治疗组。虽然期待治疗组（21%）的剖宫产率低于积极治疗组（30%），但差异无统计学意义。两组的分娩或围产儿并发症无显著差异。
足月 PROM 的期待治疗与积极治疗在分娩方式和并发症方面具有相似的结果。然而，与期待治疗相比，积极治疗显著缩短了潜伏期和诱导至分娩的时间间隔。非传染性疾病临床试验注册平台（PACTR）注册号：PACTR202206797734088。
