Objective: The objective of the study was to assess the maternal and neonatal outcome in premature rupture of membranes. Material and Methods: A prospective study was carried out in the department of Obstetrics &Gynae in Ibn Sina Medical College hospital from October'15 to September'16. The sample size was 110. The maternal and neonatal outcome of pre-labour rupture of membranes in both term and preterm pregnancies was observed and statistically analyzed. Results: Incidence of PROM (premature rupture of membrane) was commonly in primigravida (62.7%). Term PROM was higher (70.92%) than PPROM (29.09%). Aetiological analysis revealed cause is unknown in most of the cases. Infection in 26.4% cases, previous history of PROM 16.3% and history of recent coitus 9.09% cases. Patient delivered by vaginal route 70.91% and LSCS 29.09%. The PROM had higher maternal morbidity (27.8%) like post partum fever 11.8%, wound infection 4.5% and chorioamnionitis 3.6%. Also higher perinatal mortality (4.5%) and morbidity (26.4%) like respiratory distress syndrome 9.09%, birth asphyxia 4.5%, septicemia 5.8%. Conclusion: Antenatal diagnosis to prevent PROM by identifying the risk factors is an important tool in management. Steroid for fetal lung maturity, antibiotics to prevent fetal and maternal infection, induction and/or augmentation of labour in due time and skilled NICU support will speed delivery, reduce hospital stay and infection as well as decrease maternal morbidity and perinatal morbidity and mortality.
Background: Knowledge of the patterns of normal and abnormal labour, and of women’s behavior, is fundamental to the formulation of mode of delivery. It is observed that women admitted to hospital early have a higher frequency of obstetric interventions in labour than those admitted later. Objective: To study the outcome of spontaneous onset of labour in nulliparous and multiparous patients. Materials and method: During the study period of 1st July 2008 to 31st Dec 2008, 568 pregnant women admitted in Kumudini Women’s Medical College were included in this study. Mothers were observed since admission with spontaneous onset of labour and followed up till they were released from the hospital. Labour outcome was measured and mode of delivery was compared among nulliparous and multiparous women. Results: Among the nulliparous women, normal vaginal delivery occurred in 71 (23%) patients presented with early cervical dilatation (0-3 cm) and in 142 (46%) patients presented with late cervical dilatation (>4 cm). In nulliparous women caesarean section were needed in 60 (45.8%) patients in early cervical dilatation group and in 35 (19.8%) patients in late cervical dilatation group. In multiparous women, normal vaginal delivery occurred in 66 (25%) patients presented with early cervical dilatation and in 133 (51%) patients presented with late cervical dilatation whereas cesarean section were done in 35 (34.7%) patients and in 25 (15.8%) patients in the two groups respectively. Duration of labour between nulliparous and multiparous was significantly different (8 hours vs. 6 hours). Indication of caesarean section were, 61 (40%) patients due to prolong labour, 48 (34%) due to foetal distress and 44 (26%) due to cephalopelvic disproportion. Conclusion: Normal vaginal delivery occurred more and duration of labour was shorter in patients admitted with advanced labour (cervical dilatation >4cm). Delta Med Col J. Jan 2019 7(1): 16-20
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