Active versus Conservative Management of Pre labor Rupture of Membranes at Term Pregnancies and Nursing Implications

Document Type : Original Article

Authors

1 Assistant Lecturer of Maternal and Newborn Health Nursing- Faculty of Nursing- Helwan University,(

2 Professor of Obstetrics and Gynecological Nursing- Faculty of Nursing- Zagazig University

3 Lecturer of Maternity and Gynecological Nursing- Faculty of Applied Medical Sciences- MUST University

4 Professor of Obstetrics and Gynecology- Faculty of Medicine- Zagazig University

Abstract

Background: Pre- labor rupture of membranes is a spontaneous rupture of the membranes
at/or after 37 weeks gestation and before the onset of labor. The aims of the present study
were, to compare the clinical effectiveness and safety of active management versus
conservative management in women with pre-labor rupture of membranes. Also to compare
the maternal and neonatal out comes of active management versus conservative management
in women with pre-labor rupture of membranes. A Quasi experimental design was selected in
carrying out this study. The setting of the study was the labor word, at Zagazig University
Hospital. A representative sample of 160 parturient women who had premature rupture of
membranes and undergoing management according to the inclusion criteria were recruited for
this study. They were categorized into: Study group (n=80) who received oral misoprostol
50-200ug and Conservative group (n=80) who were observed for 24 hours and received the
normal management technique. The tools used for data collection were; an interview
questionnaire, Clinical assessment form, Ultrasonography, Cardio-Tocography, Medication
sheet, Partograph, and Summary of labor sheet. The results of the present study revealed that
women in the study group had shorter total duration of labor than the conservative group
(7.2±1.4hrs VS 10.1±2.5hrs respectively) and lower rate of cesarean section (6.2% &18.7%
respectively). Only one fetal death in the study group was reported compared to 3 in the
conservative group. It can be concluded that, active nursing management by using oral
misoprostol resulting in reduction in the mean duration of labour, lower percentage cesarean
section rate and better infant outcomes. The study recommended the active nursing
management using of misoprostol for faster and safer labor.

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