Maternal and Neonatal outcome in premature rupture of membranes

Abstract

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.

Risk Factors of Premature Rupture of Membrane in A Tertiary Care Hospital, Bangladesh

“…Although it is widely accepted that aetiology of PROM are multifactorial. Our study shows that most of the causes are idiopathic (46.6%) which is similar to the study done by lovereenset al and in their study it was 47.3% 12 . Anaemia is one of the most important risk factors of PROM which is 45% in our study and almost similar ( 44.5%) to the study done by another private tertiary care Hospital but 26% and 16% was in the study done by Akhter S et al, Choudhary M et al respectively 13,1,5 .…”

“…According to Akhter et al chance of increase sexual activity and increased genital infection are the most common among primigravida and in their study primigravida were 53% 13 . Incidence of preterm PROM in our study was 30.8% which was almost similar (29.09%) to the study by lovereen S et al 12 .…”

“…In the study done by Begum N, low socioeconomic status was 50% 7 . In present study maximum (61.8%) cases with PROM were primigravida which was almost similar (62.7%) and (53.33%) to the study done by lovereen S et al and Begum A et al respectively 12,4 . According to Akhter et al chance of increase sexual activity and increased genital infection are the most common among primigravida and in their study primigravida were 53% 13 .…”

“…Low socio economic status is an important risk factor. In our study 60.6% patients came from low socio economic status 5,10,12,17 . History of spontaneous abortion 15% which was almost similar to the study by Mohan S et al where it was 17.7% 10 .…”

Preterm pre-labor rupture of membranes and perinatal outcome: a prospective cohort study

“…A recent study observed that PPROM was more common in primigravida and most of the cases delivered vaginally (70.91%). Furthermore, they found that PPROM was associated with higher maternal morbidity (27.8%) and perinatal mortality (4.5%) and morbidity (26.4%) [13].…”