DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20172339

Maternal and perinatal outcome in preterm premature rupture of membranes

Jameela Diraviyam M. V., Lalithambica karunakaran

Abstract


Background: Preterm premature rupture of membranes (PPROM) occurs in 3% of pregnancies and is responsible for approximately one third of all preterm births. Objective of present study was to analyse the maternal and perinatal outcome of PPROM patients between 28 to 36 weeks +6days

Methods: A descriptive study was conducted on 141 antenatal patients between 28 to 36weeks+6days with PPROM admitted to Department of Obstetrics and Gynecology, Government TD Medical College, Alappuzha, Kerala, India from September 2014 to September 2015. After establishing the diagnosis of PPROM patients were monitored and Maternal and perinatal outcomes were studied.

Results: 77% patients had late PPROM. 60% of early PPROM latency period >24 hrs and were managed conservatively till 34 weeks. 18% had chorioamnionitis and immediate termination of pregnancy. 73% of newborns in this group needed admission due to complications of prematurity like RDS (54.54%). Perinatal mortality (2.12%) was due to sepsis. 80% of late PPROM had latency period <24 hrs and only 4% had chorioamnionitis.18.5% babies in this group had hyperbilirubinemia. There was statistically significant association between latency period and perinatal complications (p=0.001). RDS was 33% in latency period <24hrs, 18% in >24hrs and sepsis was 36% in >24hrs and 10% in <24hrs.

Conclusions: The most common cause of perinatal mortality in early PPROM is prematurity and its complications. Hence conservative management to prolong pregnancy is recommended under strict monitoring for evidence of chorioamnionitis. At the earliest evidence of chorioamnionitis termination irrespective of gestational age is warranted. In late PPROM, perinatal outcome is good. So, termination is advised as conservative management shall add to the fetal and maternal morbidity due to sepsis.

 


Keywords


Choriomnionitis, Latency period, Maternal outcome, Perinatal outcome, Sepsis

Full Text:

PDF

References


Bartfield MC, Carlan SJ. The home management of preterm premature ruptured membranes. Clini Obstet Gynecol. 1998;41(3):503-14.

Goldenberg RL, Rouse DJ. Prevention of premature birth. N Eng J Med. 1998;339(5):313-20.

Jayaram VK, Sudha S. A study of PROM: management and outcome. J Obstet Gynecol India. 2001;51:58-60.

Khuppel Ka, Curtis C, Robert LK. Premature rupture of membranes. Am J Obstet Gynecol. 1979;134(6):655-61.

Noor S, Nazar AF, Bashir R, Sultana R. Prevalance of PPROM and its outcome. J Ayub Med Coll Abbottabad. 2007;19(4):14-7.

Gandhi M, Shah F, Panchal C. Obstetric outcomes in premature rupture of the membrane (Prom). Internet J Gynecol Obstet. 2012;16(2):1-5.

Okeke TC, Enwereji JO, Okoro OS, Adiri CO, Ezugwu EC, Agu PU. The incidence and management outcome of preterm premature rupture of membranes (PPROM) in a tertiary hospital in Nigeria. Am J Clini Med Res. 2014;2(1):14-7.

Revathi V, Sowjanya R, Lavanya S. Maternal and perinatal outcome in premature rupture of membranes at term. IOSR-JDMS. 2015;14:12-5.

Singhal S, Puri M, Gami N. An analysis of factors affecting the duration of latency period and its impact on neonatal outcome in patients with PPROM. Arch Gynecol Obstet. 2011;284(6):1339-43.

Kadikar GK, Gandhi MR. A study of fetomaternal outcome in premature rupture of membranes. 2014;3(3).

Lim JJ, Allen VM, Scott HM, Allen AC. Late preterm delivery in women with preterm prelabour rupture of membranes. J Obstet Gynaecol Canada. 2010;32(6):555-60.

Magee B, Smith G. Histological chorioamnionitis associated with preterm prelabour rupture of membranes at Kingston General Hospital: a practice audit. J Obstet Gynaecol Canada. 2013;35(12):1083-9.

Emechebe CI. Determinants and complications of pre-labour rupture of membranes (PROM) at the University of Calabar Teaching Hospital (UCTH), Calabar, Nigeria. Parity. 95:100-0.