Premature rupture of membranes at term: immediate induction of labor versus expectant management

Objective: To compare the maternal outcomes of immediate induction of labor with expectant management in women presenting with premature rupture of membranes (PROM) at term.Methods: One hundred and fifty two women with PROM at term were randomized into either immediate induction of labor with oxytocin or expectant management for a period of 12 hours. The primary outcome measure was the incidence of clinical endometritis in each group. Secondary outcomes were the mode of delivery, the neonatal outcome and the proportion of women in the expectant management group that progressed to spontaneous labor.Results: The immediate induction arm had a lower caesarean section rate, (7.9% vs 28.9%, P=0.001), higher spontaneous vaginal delivery rate (92.1% vs 71.1%; P=0.001) and lower incidence of clinical endometritis (0% vs 5.3%, P=0.006), when compared with the expectant management arm. The estimated duration of labor was shorter in the expectant management arm (8.9±2.17hours vs 10.6±2.35hours; P=<0.001). Neonatal morbidity rates were comparable in both groups.Conclusion: Immediate induction of labor in women with PROM at term resulted in significantly lower rate of infectious morbidity without increasing the risk of operative delivery. It is therefore recommended as the management option of choice.Keywords: Premature rupture of membranes, induction of labor, endometriti

Awareness of cervical cancer and its prevention among young women in Ekiti state, south-west Nigeria.

Background: Cancer of the cervix is a major public health issue in the developing countries. The burden of the disease is considerable with associated morbidity and mortality among women in their productive years. The lack of awareness and adequate information about cervical cancer and its prevention may be responsible for the large burden of cervical cancer on the developing countries.Objective: To assess the knowledge of cervical cancer, its risk factors and prevention among young women in Ekiti State.Methods: This was a descriptive cross-sectional questionnaire based survey of young women aged 15-24 years in randomly selected local government areas in Ekiti State in June 2013. Means, frequencies and percentages were determined and frequency tables were generated using SPSS software version 16.0.Results: A total of 444 young females participated in this study. Among the respondents, 69.4% were sexually active with only a quarter consistently using condom. Only 54.3% had heard cervical cancer, 2.9% knew the risk factors and a quarter knew no risk factor for cervical cancer. A tenth of the respondents knew about human papilloma virus (HPV) and a similar number knew about the HPV vaccine. Only 9% have heard about Pap smear while 1.4% have had pap smear at least once.Conclusion: Our study revealed poor knowledge of cervical cancer and its prevention among young women in this environment. There is a need for increase in public awareness of cervical cancer and its prevention. Provision of adequate information, community mobilization, proper service delivery, women empowerment and political will are essential in reducing this burden in the developing world