Success rate, Maternal and Perinatal outcome, and Associated factors of induction for Prelabour rupture of membrane in three teaching hospitals.
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Date
2025
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Addis Ababa Uinverstiy
Abstract
Prelabour rupture of membranes refers to the loss of integrity of fetal membranes
prior to the onset of clinically apparent labour contractions. The major issue in managing a
woman with PROM at term is whether to follow her expectantly or proceed for delivery. Among
the factors to consider are possibility of failed induction, caesarean delivery, length of labour,
cost, length of hospitalization and risk of maternal and neonatal complications.
Objective: the objective of the study is to assess the success rate, maternal and perinatal
outcomes, and factors affecting of induction for prelabour rupture of membrane in the three
teaching Hospitals of Addis Ababa University.
Methods: Facility based cross-sectional study was employed in the three affiliate teaching
hospitals of Addis Ababa University. The study subjects were recruited sequentially until the
calculated sample size of 374 is achieved. The data were collected by interview & reviewing
participants‘ clinical records. The data were entered, clearing and analysis by SPSS version 25.
Logistic regression analyses were employed to identify factors associated with the outcome
variable. Using 95% CI, variables with a p-value <0.05 were identified as statistically significant
factors.
Result: Sixty seven percent (n= 250) of 374 participants with PROM had a successful induction
of labor. Multiparity (Odd‘s ratio= 14.0, 95% CI: 3.78, 52.16), term PROM (Odd‘s ratio= 4.9,
95% CI: 1.04, 23.29), and absence of intrapartum complications (Odd‘s ratio= 15.0, 95% CI:
13.37, 65.13) were significantly associated with higher odds of successful induction. Maternal
complications occurred in 6.4% (n= 24) of participants, mainly postpartum hemorrhage (n= 21,
5.6%) and surgical site infection (n= 3, 0.8%).
Poor perinatal outcomes were observed in 18% (n= 67) of neonates, with 16% (n= 59) requiring
NICU admission and a neonatal mortality of 2.7% (n= 10). Multiparous women had a better
perinatal outcomes (Odd‘s ratio= 0.39, 95% CI: 0.17, 0.92), while hypertensive disorders (Odd‘s
ratio= 13.4, 95% CI: 1.03, 44.92) and non-spontaneous deliveries, OVD (Odd‘s ratio= 28.2, 95%
CI: 2.73, 91.31) and CS (Odd‘s ratio= 6.2, 95% CI: 2.58, 14.96) significantly increased the risk.
Conclusion and recommendation: The success of induction was good, and is comparable to the
findings of studies done in other centers. Multiparity, term PROM, and absence of intrapartum
complications were associated with successful induction. Strengthen antenatal risk assessment to
identify women at higher risk for poor outcomes; those with hypertensive disorders and
primigravidity is important to improve the outcome.
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Keywords
Induction, Prelabour Rupture of Membranes, AAU