Abstract
Introduction: Prelabour Rupture of Membranes (PROM) is defined as the rupture of fetal membranes with a latent period before the onset of spontaneous uterine activity. The length of this latent period varies in different definitions from not being specified to up to 8 to 12 hours. If the membranes rupture after 37 weeks of gestation is termed as Term PROM. If the rupture of membranes (ROM) occur after 28 weeks but before 37 weeks of gestation it is termed as the Preterm Premature Rupture of Membranes (PPROM).
Aim of the study: To assess fetal and maternal outcome in prelabour rupture of membranes at term.
Materials and Methods: A Prospective hospital based study was conducted between the period of November 2015 and August 2017 on 100 pregnant women after 37 completed weeks with prelabour rupture of membranes admitted in labour room under the Department of Obstetrics and Gynaecology of Rajah Muthiah Medical College and Hospital. They are evaluated using a preset proforma meeting the objectives of the study. They were evaluated by means of a personal interview, by clinical examination and they were managed according to our institutional protocol. After delivery, the maternal and fetal outcome was studied till discharge. The study was performed in accordance with the ethical principles.
Results: In this study, the incidence of PROM was more in the age group of 20 – 29 years which was around 85%. In the present study, PROM was more in primigravida, about 78%. In this study, 34% of PROM occurred between 38 to 39 weeks. Among 100 cases of PROM, 85 cases had come with clear liquor and 15 cases had meconium stained liquor. Among 100 patients 66 delivered by LSCS and 34 by vaginal route. Here, the most common indication for LSCS was Fetal distress (39%), followed by CPD (15%). Maternal morbidity was 11%. Maternal complications include postpartum fever (4%), PPH (2%) and wound infection (2%). etc Perinatal morbidity include birth asphyxia (3%), hyperbilirubinemia (4%), Respiratory distress (8%) etc.
Keywords: Prelabour Rupture of Membranes (PROM), maternal and perinatal outcome.
References
- Akyol, D., Mungan, T., Unsal, A. & Yuksel, K. (1999) Prelabour Rupture of the Membranes at Term—No advantage of Delaying Induction for 24 Hours. Australia and NZ Journal of Obstetrics & Gynecology, 39(3): 291-295.
- Dare MR, Middleton P, Crowther CA, Flenady VJ, Varatharaju B. Planned early birth versus expectant management (waiting) for prelabour rupture of membranes at term (37 weeks or more). Cochrane Database of Systematic Reviews 2006, Issue 1. Art. : CD005302.DOI: 10.1002/ 14651858. CD005302.pub2
- Duff, P., Huff, R.W. & Gibbs, R. (1984) Management of Premature Rupture of Membranes and Unfavorable Cervix in Term Pregnancy. Obstetrics & Gynecology 63(5): 697-702.
- Grant, J.M., Serle, E., Mahmood, T., Sarmandal, P., & Conway, D.I. (1992). Management of prelabour rupture of membranes in term primigravidae: a report of a randomized prospective trial. British Journal of Obstetrics & Gynaecology, 99(7): 557-562.
- Hannah, M.E., Ohlsson, A., Farine, D., Hewson, S.A., Hodnett, E.D., Myhr, T.L. et. al. (1996). Induction of Labor Compared with Expectant Management for Prelabor Rupture of the Membranes at Term (TERM PROM study). New England Journal of Medicine, 334(16), 1005-1010.
- Kappy A.K. et. al. (1979) Premature Rupture of Membranes: A conservative approach. American Journal of Obstetrics & Gynecology 134(6): 655-661.
- Marshall, V.A. (1993) Management of premature rupture of membranes at or near term. Journal of Nurse-Midwifery, 38(3): 140-145.
- McGregor, JA, French, JI. (1997) Evidence-based prevention of preterm birth and rupture of membranes: infection and inflammation. Journal of the Society of Obstetricians and Gynaecologists of Canada, 13: 835-852.
- Mozurkewich, E.L. & Wolf, F.M. (1997) Premature rupture of membranes at term: a meta-analysis of three management schemes. Obstetrics & Gynecology, 89(6):1035-1043.
- Rydhstrom, H & Ingemarsson, I. (1991) No Benefit from conservative management in nulliparous women with premature rupture of membranes (PROM) at term. Acta Obstetrica Gynecologica Scandinavia, 70: 543-547.
- Russell, K., & Anderson, G. (1962) The aggressive management of ruptured membranes. American Journal of Obstetrics and Gynecology, 83(7): 930-937.
- Shalev, E., Peleg, D., Eliyahu, S. & Nahum, Z. (1995). Comparison of 12- and 72- hour Expectant Management of Premature Rupture of Membranes in Term Pregnancies. Obstetrics & Gynecology, 85(5): 766-768.
- Shubeck, F., Benson, RC., Clark Jr, WW., Berendes, H., Weiss, W., & Deutschberger, R. (1966). Fetal hazard after rupturing of membranes. A report from the Collaborative Project. Obstetrics & Gynecology, 28(1), 22-31.
- Tan, BP & Hannah, M.E. (2001) Oxytocin for prelabour rupture of membranes at or near term (Cochrane Review). In: The Cochrane Library, No. 2., Oxford: Update Software, 2001.
- Wagner, M.V., Chin, V.P., Peters, C.J., Drexler, B., & Newman, L.A. (1989) A Comparison of Early and Delayed Induction of Labor with Spontaneous Rupture of Membranes at Term. Obstetrics & Gynecology, 74(1):93-97.
Corresponding Author
Dr S. Amala
Final Year Post Graduate, Department of Obstetrics and Gynaecology,
Rajah Muthiah Medical College, Annamalai University, Chidambaram
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.
DOI: https://dx.doi.org/10.18535/jmscr/v5i11.71
