Study of fetomaternal outcome in Premature Rupture of Membranes

Dr. Tushar Tatyaba Palve; Dr. Rangan Bhattacharya

Volume : VI, Issue : XI, November - 2017

Study of fetomaternal outcome in Premature Rupture of Membranes

Dr. Tushar Tatyaba Palve, Dr. Rangan Bhattacharya

Abstract :

Premature rupture of memanes refers to rupture of memanes prior to the onset of labour, occurring in 3% of pregnancies and causing around 25-30% of all preterm deliveries. PROM patients are at a risk of the ascent of pathogenic microorganism from the lower genital tract leading to complications such as intrauterine infections and perinatal morbidity and mortality, including respiratory distress syndrome, neonatal sepsis, umbilical cord prolapse, placental auption, and IUFD. With the advent of antibiotics and foetal and maternal monitoring, perinatal and maternal complications of PROM can be prevented.

Methods: This is retrospective observational study conducted in an Unit of OBGYN Department in a tertiary hospital, Mumbai, from March to August 2017 in patients diagnosed as PROM ( >28week gestation). Total number of such patients was 60. Diagnosis was confirmed and results were analysed.

Results: Out of 60 cases, 21.7% were unbooked. Maximum cases were in the age group of 20-25 years(55%). Most cases presented at 37-40 weeks gestation(68.3%)and were primigravida (51.7%). 18.3% cases were of preterm PROM. 73.3% patients delivered vaginally. 18.3% cases were delivered by LSCS without trial of labour, the commonest indication of which was malpresentation(36.2%). 68.3% cases had a third trimester USG s/o AFI >10cm. 10% had a third trimester USG s/o AFI < 5 cm (Lowest AFI = 1cm).Of these, 4 delivered by LSCS without trial of labour(commonest indication: sev Oligo/IUGR) and 2 delivered vaginally. 8.3% cases delivered by LSCS after being given a trial of labour. The commonest indication of LSCS after trial of labour was fetal distress(60%). Majority of the babies had a birth weight ranging from 2.5-3kg (50%). Out of 60, 16 neonates required NICU admission(26.7%), commonest indication being Respiratory distress (7 out of 16 cases). 5 out of 16 NICU admissions were for Low birth weight(<1.8 Kg). Maternal complications seen were fever(10%), wound gape(3.33%) and anemia, requiring blood transfusion (3.33%).

Conclusion: PROM is associated with poor fetomaternal outcome which can be prevented by early diagnosis and prompt management.