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CONFERENCE PROCEEDING
The outcome of expectant management of premature rupture of membranes (PROM) in midwifery-led care setting
1
Klinik Utama Cikal Mulia, Midwifery, Jakarta, Indonesia
Eur J Midwifery 2026;10(Supplement 1):A637
ABSTRACT
BACKGROUND:
Despite its natural occurrence, PROM is frequently met with medical interventions. In many health systems, PROM leads to prompt labour induction or even caesarean delivery due to fears of infection, fetal distress, or prolonged labour. However, studies indicate lower rates of maternal complications when managing PROM expectantly. This strategy respects the natural physiology of birth while balancing safety through timely surveillance.
OBJECTIVES:
This study aims to evaluate the outcomes of expectant management of PROM in a midwifery-led care setting, with a particular focus on neonatal outcomes, including the incidence of asphyxia, infection, and the need for neonatal resuscitation.
METHODS:
A quantitative study with cross-sectional design to find the relationship between the duration of PROM with the incidence of neonatal asphyxia. Data were collected from 74 birth records in Cikal Mulia from January 2022 to December 2024. Data analysis was used the Chi-square test to define the associations between categorial variable, such as duration of PROM labour and neonatal Apgar score to identify asphyxia.
RESULTS:
The quantitative analysis showed that there was no statistically significant relationship between the duration of PROM and the risk of neonatal asphyxia (p > 0.05).
CONCLUSIONS:
These findings support the growing body of literature advocating for expectant management of PROM in low-risk, term pregnancies, especially within midwifery-led care models that emphasize individualized, woman-centred care. PROM should not automatically trigger labour induction or surgical delivery. Instead, it should be viewed as a natural entry point into labour, allowing time for spontaneous progression under observation.
KEY MESSAGE:
This study reinforces the understanding that premature rupture of membranes (PROM) at term should not be viewed as a pathological complication, but rather a physiological variation within the normal spectrum of childbirth. The role of the midwife is to ensure the absence of danger sign during expectant management, while continuing support and facilitate physiological process of labour. Poster session 2 (Group A)
Despite its natural occurrence, PROM is frequently met with medical interventions. In many health systems, PROM leads to prompt labour induction or even caesarean delivery due to fears of infection, fetal distress, or prolonged labour. However, studies indicate lower rates of maternal complications when managing PROM expectantly. This strategy respects the natural physiology of birth while balancing safety through timely surveillance.
OBJECTIVES:
This study aims to evaluate the outcomes of expectant management of PROM in a midwifery-led care setting, with a particular focus on neonatal outcomes, including the incidence of asphyxia, infection, and the need for neonatal resuscitation.
METHODS:
A quantitative study with cross-sectional design to find the relationship between the duration of PROM with the incidence of neonatal asphyxia. Data were collected from 74 birth records in Cikal Mulia from January 2022 to December 2024. Data analysis was used the Chi-square test to define the associations between categorial variable, such as duration of PROM labour and neonatal Apgar score to identify asphyxia.
RESULTS:
The quantitative analysis showed that there was no statistically significant relationship between the duration of PROM and the risk of neonatal asphyxia (p > 0.05).
CONCLUSIONS:
These findings support the growing body of literature advocating for expectant management of PROM in low-risk, term pregnancies, especially within midwifery-led care models that emphasize individualized, woman-centred care. PROM should not automatically trigger labour induction or surgical delivery. Instead, it should be viewed as a natural entry point into labour, allowing time for spontaneous progression under observation.
KEY MESSAGE:
This study reinforces the understanding that premature rupture of membranes (PROM) at term should not be viewed as a pathological complication, but rather a physiological variation within the normal spectrum of childbirth. The role of the midwife is to ensure the absence of danger sign during expectant management, while continuing support and facilitate physiological process of labour. Poster session 2 (Group A)
| eISSN: | 2585-2906 |
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