Volume : 6, Issue : 11, November - 2017

Study of fetomaternal outcome in Premature Rupture of Membranes

Dr. Tushar Tatyaba Palve, Dr. Rangan Bhattacharya

Abstract :

<p>&nbsp;Premature rupture of memanes refers to rupture of memanes prior to the onset of labour<span style="background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;">, occurring in 3% of pregnancies and causing around 25-30% of all preterm deliveries. </span>PROM patients are at a risk of <span style="background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;">the ascent of pathogenic microorganism from the lower genital tract leading to complications such as intrauterine infections and perinatal morbidity and mortality, </span>including respiratory distress syndrome, neonatal sepsis, umbilical cord prolapse, placental auption, and IUFD.<span style="background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;"> </span>With the advent of antibiotics and foetal and maternal monitoring, perinatal and maternal complications of PROM can be prevented.</p> <p class="MsoNormal"><b><span lang="EN-IN">Methods:</span></b><span lang="EN-IN"> This is retrospective observational study conducted in an Unit&nbsp; of OBGYN Department&nbsp; in a tertiary hospital, Mumbai,&nbsp; from&nbsp; March to August 2017 in patients diagnosed as PROM ( &gt;28week gestation). Total number of such patients was 60. Diagnosis was confirmed and results were analysed.<o:p></o:p></span></p> <p class="MsoNormal"><b><span lang="EN-IN">Results:</span></b><span lang="EN-IN"> Out of 60 cases, 21.7%&nbsp; were unbooked. Maximum cases were in the age group of 20-25 years(55%).&nbsp; 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%&nbsp; cases had a third trimester USG s/o AFI &gt;10cm.&nbsp; 10% had a third trimester USG s/o AFI &lt; 5 cm&nbsp; (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%).&nbsp; 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(&lt;1.8 Kg). Maternal complications seen were fever(10%), wound gape(3.33%) and anemia, requiring blood transfusion (3.33%).<o:p></o:p></span></p> <p class="MsoNormal" style="margin-bottom: 8.3pt; line-height: normal; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;"><span lang="EN-IN">Conclusion: PROM is associated with poor fetomaternal outcome which can be prevented by early diagnosis and prompt management.</span><span lang="EN-IN" style="font-size: 12pt; font-family: &quot;Times New Roman&quot;, serif;"><o:p></o:p></span></p>