Title: Premature Rupture of Membranes-Clinico Epidemiological Perspective
Authors: Vinita Agrawal, Ashish Agrawal, Hitesh Parmar, Prateek Porwal
DOI: https://dx.doi.org/10.18535/jmscr/v4i12.134
Abstract
Background: Aim of the study is to compare demographic data, study the outcome of pregnancy in patients with Premature Rupture of Membranes (PROM) and establish correlation between latency of PROM with outcome of pregnancy, maternal & neonatal complications.
Material and Method: A hospital based prospective study was conducted from 01 Jan 2015 to 30 June 2016 on 209 cases of spontaneous premature rupture of membranes, in the Department of Obstetrics and Gynecology, Index Medical College Hospital & Research Centre, Indore. Pregnant women, who presented with spontaneous premature rupture of membrane before onset of labor pains, were actively managed, by induction of labor, and those in labor were managed accordingly with single dose of prophylactic antibiotic. Mode of delivery and indication of CS along with maternal and neonatal outcome were recorded. The results were statistically analyzed regarding their correlation with latency with mode of delivery, perinatal morbidity and mortality and maternal morbidity.
Results: The mean age in our study was 23.13 ± 3.31 years, with (67%) women were from rural area, 48.3% were booked and 62.7% was primigravida. In majority of the women, the latency period was between 0-6 hours (i.e. 43.5%). In 87 (41.6%) women the mode of delivery was LSCS, in 107 (51.2%) mode of delivery was normal delivery. Most common indication for LSCS was fetal distress in 52 (59.8%), Sepsis (7.7%) and meconium aspiration syndromes (4.8%) were the most common neonatal complications observed. Urinary tract infection was the most common maternal complications seen in our study, followed by sepsis and chorioamnionitis. Statistically significant association of latency period was found with mode of delivery, neonatal complication and puerperal complications (P < 0.05)
Conclusion: PROM is a major cause for increased perinatal morbidity and mortality. As prevention of PROM is difficult due to obscurity of aetiology, one has to concentrate more on management of PROM to reduce its complications. To achieve this, proposed plan of "Aggressive management “that gives a high rate of successful vaginal deliveries and decreases the maternal and neonatal morbidity and mortality.
Keywords: Chorioamnionitis, Latency, PROM
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