A study on feto-maternal outcome in patients with premature rupture of membranes

Background: Premature rupture of membranes (PROM) refers to a patient who is beyond 37 weeks' gestation and has presented with rupture of membranes (ROM) prior to the onset of labor. Patient with PROM presents with leakage of fluid, vaginal discharge and pelvic pressure, but they are not having contraction. It occurs in 3 percent of pregnancies and is the cause of approximately one third of preterm deliveries. It can lead to significant perinatal morbidity, including respiratory distress syndrome, neonatal sepsis, umbilical cord prolapse, placental abruption, and fetal death. Appropriate evaluation and management are important for improving neonatal outcomes. The risk of intrauterine infection increases with the duration of ROM. Evidence supports the idea that induction of labor, as opposed to expectant management, decreases the risk of chorioamnionitis without increasing the cesarean delivery rate.Methods: The present prospective study was conducted in the Department of Obstetrics and Gynecology and associated Dr. B.R.A.M. Hospital Raipur (C.G.), India from January to December 2013 among the patients diagnosed as premature rupture of membrane with women complain of leaking attending antenatal OPD and antenatal ward. On admission detailed history was taken. General and Systemic examination were done including Per Abdomen, Per Speculum and per vaginum carried out and investigations were done as per protocol. Diagnosis of PROM was confirmed by any of this method. Continuous monitoring of maternal and fetal condition done, antibiotics was given intra/ post natal period. P/ V exam were done when necessary. Investigations done and maternal and fetal outcome were noted.Results: More number of unbooked cases was found in study group in comparison to control group. Maximum women were in the age group of 20-25 years. Majority of cases in both the groups had pregnancy more than 36 weeks. PROM results in oligohydramnios due to drainage of liquor amnii. Majorities of the babies were underweight among mothers with PROM. Thus the better fetal outcome was associated with term gestational age. Higher chances of maternal complication were found among mothers with PROM.Conclusions: From the above study, it can be concluded that PROM is associated with poor fetomaternal outcome. Early diagnosis and prompt management is required for better outcome of mother and baby