Premature rupture of membrane and perinatal outcome

Abstract

Objective: To find out the complications of a pregnant woman with premature rupture of membrane (PROM) and assess the outcome of it. Materials and

Methods: This prospective study was carried out at the Department of Obstetrics & gynecology of Coronel Malek Medical College Hospital, Manikgonj, Bangladesh from January 2020 to December 2020. All pregnant women admitted with PROM during this period were taken as the study population. After taking proper history they were categorized as a term or preterm PROM on the basis of duration of gestation estimated from 1st day of last menstrual period (LMP), previous antenatal records, clinical examination & also previous ultrasonography (USG) reports. Out of sociodemographic characteristics, age distribution and gravidity were noted. The diagnosis was done on the basis of examination and investigations. All the women with PROM were then followed up, management was given according to protocol and a cesarean section was performed according to indication. Birth weight and Apgar score of newborns were noted after delivery.

Results: There were 297 cases of PROM recorded among 4461 admitted obstetrical patients over one year period. The hospital incidence of PROM was found to be 6.6%. Among them, 57.6% of patients were admitted at term and 42.4% of patients came before 37 completed weeks of gestation. Most of the pregnant women were between 20-24 years of age (43.7%), 43.2% were primigravida (56.6%) were multigravida. About 48.5% of women presented with different complications associated with PROM. Among which 15.7% of patients had oligohydramnios, 8.5% of patients presented with chorioamnionitis suggested by culture report of the high vaginal swab. Urine for culture and sensitivity was also done. About five (5.2%) developed premature labor before the 37th week of gestation. About 10% of women developed obstetric complications (failed trials) associated with medical diseases. Seventy-seven patients were delivered by cesarean section, 16.2% vaginally, 4.04% patients responded to conservative management and 2.5% patients were referred to a tertiary center for extreme prematurity with associated complicating factors. Most of the babies (38.4%) were born with birth weight between 2.1- 2.5kg and 10.3% of babies were less than 1.5kg.

Conclusion: Term PROM was more in comparison to PPROM and most of them were multigravida. The cesarean section rate was high. Most common complication of was subclinical urogenital infection (53%) next oligohydramnios (25%) & (13.5%) women presented with chorioamnionitis.