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

Abstract

Background: Preterm Prelabor Rupture of Membranes (PPROM) is one of the common causes of increased perinatal morbidity and mortality. Objectives: To know the perinatal outcome in antenatal women with Preterm Prelabor Rupture of Membranes. Methods: Present prospective cohort study was conducted in rural tertiary center of Northern India over one year (January-December 2018) on 75 antenatal women at gestation ≥28 weeks with Preterm Prelabor Rupture of Membranes. Onset of labor and mode of delivery was recorded in all participants. Immediately after birth, neonatal Apgar scores, birth weight, gender, NICU admission, need for oxygen or intubation, complications and perinatal mortality (early neonatal deaths and stillbirths) were recorded. Results: Of total 3,085 deliveries (at gestation ≥28 weeks) during the study period, 75 (2.4%) antenatal women had PPROM, of which 72 (96.0%) had preterm delivery and three (4.0%) were managed conservatively and delivered atterm. Four (5.6%) had iatrogenic preterm delivery (labor was induced) due to feto-maternal risk factors and 68(94.4%) went into spontaneous preterm labor. The most common mode of delivery was vaginal (81.3%) followed by Lower segment cesarean section (18.7%). Of 75 neonates delivered, 70 (93.3%) were live, 03(4.0%) stillbirths and 02(2.7%) early neonatal deaths. The mean neonatal birth weight was 2.02±0.50 Kg (p=0.000). Sixty-seven (89.3%) neonates had poor 1-minute Apgar scores, 17(22.7%) had 5-minutes Apgar score <7, 40 (53.3%) required NICU admission, 06(8.0%) intubated, 45(60.0%) developed neonatal complications. The most common neonatal complication was prematurity (58.7%) followed by Respiratory distress syndrome (44.0%). Conclusion: Preterm Prelabor Rupture of Membranes was significantly associated with adverse perinatal outcome.