Abstract
Background: This is an Prospective observational analytical study carried out in department of obstetrics and Gynecology,Hi-Tech Medical College & Hospital, Bhubaneswar, in a tertiary care center to determine the factors influencing fetal and maternal outcome, prognosis, morbidity and mortality in preterm premature rupture of membrane cases.
Methods: The present study is a prospective observational study of perinatal and maternal outcome in 100 cases of preterm premature rupture of membranes in between 34-37 weeks gestation with singleton pregnancy, from 1st Nov 2016 to 31st Oct 2018. Patients with medical complications like anemia, preexisting hypertension, diabetes, vascular or renal disease, multiple gestations, uterine or fetal anomalies etc. are excluded from the study. Detailed history, physical examinations were carried out and appropriate management instituted as per individual patients need.
Results: In this study maternal morbidity was 35%. Perinatal morbidity was 68% and most common causes were hyperbilirubinemia (23%), Sepsis (15%). Perinatal mortality was seen in 1% and mainly due to very LBW. Fifty Eight (58%) neonates were delivered by cesarean. The main indications for cesarean being fetal distress (43.3%) followed by non progress of labour (36%).
Conclusions: PPROM is one of the important causes of preterm birth that can result in high perinatal morbidity and mortality along with maternal morbidity. Looking after a premature infant puts immense burden on the family, economy and health care resources of the country. An understanding of gestational age dependent neonatal morbidity and mortality is important in determining the potential benefits of conservative management of preterm PROM at any gestation.
Keywords: PPROM, Perinatal morbidity.
References
- Caughey AB, Robinson JN, Norwitz ER. Contemporary Diagnosis and Management of Preterm Premature Rupture of Membranes. Rev. Obstet Gynecol. 2008;1(1):11-22.
- Fernando Arias; Premature rupture of the membrane, “Practical guide to high risk pregnancy and delivery”.3rdEd; Elsevier, New Delhi, 2008;220-237.
- Pandey S, Dave A, Bandi S. Maternal and fetal outcome in cases of preterm premature rupture of membranes. J ObstetGynaecol India.2000;50:63.
- Noor S, Fawwad A, Shahzad H, Sultana R, Bashir R. Foetomaternal outcome in patients with or without premature rupture of membranes. J Ayub Medical College Abbottabad.2010;22(1):164-7.
- Okeke TC, Enwereji JO, Okoro OS, Adiri CO, Ezugwu EC, Agu PU, et al. The incidence and management outcome of preterm premature rupture of membranes in a tertiary hospital in Nigeria. Am J Clinic Med Res. 2014;(2)1:14-17.
- Triniti A, Suthatvorawut S, Pratak O. Epidemiologic study of cervical swab culture in preterm premature rupture of membrane (PPROM) at Ramathibodi Hospital. Thai J ObstetGynaecol.2008;16(3):173-8.
- Kadikar GK, Gandhi MR, Damani SK. A Study of Feto-Maternal Outcome in Cases of Premature Rupture of Membrane. IJSR. 2014;3(3):299-301
- Carroll SG, Philpott-H J, Nicolaides KH. Amniotic fluid gram stain and leukocyte count in the prediction of intrauterine infection in preterm prelabouramniorrhexis. Fetal Diag Therapy.1996;11(1):1-5.
- Kamala Jayaram, ScailaSudha, A study of premature rupture of membranes Management and outcome. J ObstetGynaecol India.2001;51(2):58-60.
- ACOG Committee on Practice Bulletins –Obstetrics, authors. Clinical Management guidelines for Obstetrician-Gynecologists. (ACOG Practice Bulletin No 80: premature rupture of membranes). Obstet Gynecol. 2007;109(4):1007-19.
- TavassoliF, Ghasemi M, Mohamadzade A, Sharifian J. Survey of pregnancy outcome in preterm premature rupture of membrane in AFI <5 and >5. Oman Med J. 2010;25(2):118-23.
- Anjana D, Reddi R. Premature rupture of membrane: A clinical study. J ObstGynecol India1996;46:63-76.
- Kumaran A, Penna LK. prelabor ROM. Management of labor, Orient Longman.2005:306-18.
- Russell KP, Anderson GV. The aggressive management of ruptured membranes. Am J Obstet Gynecol. 1962;83(7):930-7.
Corresponding Author
Dr Ramakanta Sahoo
3rd yr PG Student, Dept. of Obstetrics & Gynaecology, Hi-Tech Medical College & Hospital, Bhubaneswar, 751010 , Odisha, India
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.
DOI: https://dx.doi.org/10.18535/jmscr/v7i1.91
