Early vs Late Induction with Oral Misoprostol in Prelabor Rupture of Membranes: A Randomized Controlled Trial

Introduction: Prelabor rupture of membranes (PROM) occurs when the amniotic membranes rupture before labor begins, typically after 37 weeks of gestation.Due to differing opinions on when and how to induce labor after PROM, this study analyzed delivery intervals and complications in women with low Bishop scores.It compared those induced within 6 hours of membrane rupture to those induced after a 12-hour delay using oral misoprostol.Methodology: This prospective, randomized, single-blinded study was conducted at a tertiary care center in Eastern India.It aimed to compare delivery intervals, oxytocin needs, and feto-maternal outcomes for early (group A) vs delayed (group B) inductions.Eighty women were randomly assigned, ensuring blinding.Group A received 50 µg of misoprostol immediately, with repeat doses administered every 4 hours as needed, and oxytocin was administered after 6 hours if contractions remained inadequate.Group B had conservative management for 12 hours, followed by induction with the same regimens as group A. Dosing and oxytocin protocols were similar for both groups, with detailed documentation of maternal and fetal outcomes.Results: Women induced within 6 hours had significantly shorter PROM delivery intervals than those managed conservatively for 12 hours, with no differences in delivery modes or complications.Discussion: The study found that expectant management required fewer interventions, while early inductions resulted in earlier deliveries without additional risks.This approach may improve patient satisfaction and alleviate resource pressures in healthcare settings.Conclusion: Early induction benefits women with PROM over expectant management.