Comparative Maternal Outcomes of Expectant Management versus Immediate Induction in Primigravida Women with Term Prelabor Rupture of Membranes: A Hospital-Based Comparative Study

Background: Term prelabor rupture of membranes (PROM) is a common complications in pregnancy.


Objective: The study aims to compare maternal outcomes and complications between conservative management and immediate induction of labor for primigravidas with term PROM.


Methods: A prospective comparative study conducted at the Department of Obstetrics and Gynecology, Omdurman Military Hospital in Khartoum State. A total of 222 primigravida with singleton term pregnancies, with confirmed prelabor rupture of membranes (PROM). Among these, 111 women received expectant management, while 111 women received immediate labor induction. Data were collected via structured questionnaire, and analyzed using SPSS.


Results: Immediate induction resulted in vaginal delivery in 49.5% of women, cesarean section in 40.6%, and instrumental delivery in 9.9%. In contrast, expectant management showed higher vaginal delivery rates (60.4%), with cesarean and instrumental deliveries at 36.0% and 3.6%, respectively; this difference was statistically significant (p = 0.031). Maternal complications were more frequent with induction, including postpartum hemorrhage (18.9% vs. 3.6%), infections (7.2% vs. 1.8%), and puerperal fever (4.5% vs. 0.9%). Overall, complication rates were significantly higher in the induction group (p < 0.001).


Conclusion: A primigravida with term prelabor rupture of membranes, expectant management is more safe and beneficial to the mother. This has been associated with higher rates of vaginal deliveries and fewer rates of caesarian sections, postpartum hemorrhage, infections, and puerperal fever, provided there are no contraindications.