Background: Premature rupture of membranes (PROM) has an incidence of about 5-10% of all pregnancies and is a significant event as it can cause maternal complications, neonatal morbidity and mortality. Some believe that the expectant management of PROM at term reduces the perinatal and maternal morbidity, and immediate induction of labour leads to high rate of caesarean section. Some authors reported a significant increase in the rates of neonatal, maternal infection and foetal distress if delivery occurs over 24 hours after PROM. Thus, a data is required to manage the cases of PROM to effect safe delivery for both mother and baby. The objective of the study was to compare the neonatal and maternal outcomes between immediate and delayed induction with tab misoprostol in term PROM. Methods: This study was conducted in Department of Obstetrics and Gynaecology, Command Hospital Air Force, Bangalore as a randomized comparative interventional study on 60 patients with confirmed PROM at term 37 to 40 weeks gestation. These patients were randomly divided into two groups by using computer generated random system of allocation after fulfilling the inclusion and exclusion criteria. Group A (immediate) received misoprostol within 6 hours of PROM and Group B (delayed) received misoprostol after 6 hours of PROM. history was elicited regarding age, menstrual and obstetric history with enquiry regarding the time of rupture of membranes, duration and amount of leaking with general, systemic and detailed obstetric examination. Augmentation of labour if required was done with oxytocin infusion. Results: The number of misoprostol tablets needed for induction varied between the two groups. There was difference in maternal and neonatal morbidity and which was statistically significant (p value <0.05). Among delayed group, 6 (20%) subjects had maternal morbidity (intrapartum fever, GIT symptoms, PPH, LSCS) and 6 (20%) neonatal morbidity (foetal distress, meconium aspiration syndrome, neonatal sepsis, NICU admission) was recorded. No maternal complication among immediate induction group whereas one case of respiratory distress observed in neonates.

Keywords: Labour Induction; Oral Misoprostol; Premature Rupture of Membranes; Immediate and Delayed.