FOETOMATERNAL OUTCOME IN PATIENTS WITH OR WITHOUT PREMATURE RUPTURE OF MEMBRANES
AbstractBackground: Preterm premature rupture of membranes is responsible for one third of all preterm birthsand is associated with significant maternal, foetal and neonatal risks. The objectives were to comparethe foeto-maternal outcome in patient with and without preterm premature rupture of membranes.Method: This prospective comparative study was conducted in Gynae-C Unit of Ayub TeachingHospital from Sep 2005 to Mar 2006. Total 170 cases were recruited in the study, out of which 85 hadPreterm Premature Rupture of Membranes (PPROM), and 85 had preterm labour without PROM.Patients’ data were recorded on a performa. Maternal outcome was measured on the basis of presenceof fever and mode of delivery. Foetal outcome was measured on the basis of weight of the baby, andpresence of infection (fever), APGAR score and neonatal death. Analysis was performed using SPSS-10. Results: The primary data arranged in groups was divided into PPROM and no-PPROM groups.The PPROM was found to be frequent in younger age group between 15–25 years while no-PPROMwas common among the age group between 26–35 years (p=0.002). Lower socioeconomic class andhistory of previous one or more preterm delivery was significantly associated with PPROM (p=0.001).Maternal fever was also significant in the PPROM group (p=0.01). Low birth weight was statisticallysignificant in the PPROM group. Majority of the babies born to mother were either extremely low birthweight or low birth weight, i.e., between 1–25 kg p-value 0.005. Low APGAR score at the time ofdelivery (p=0.01) and foetal infection (p=0.002) between the PROM and no-PPROM group was foundto be statistically significant Neo-natal deaths was also higher in the PPROM group as compared to noPPROM group (11 verses 2) (p=0.009). Conclusion: In our study premature rupture of membrane hadincreased neonatal morbidity and mortality as compared to preterm birth. Strategies should bedeveloped for its prevention.Keywords: Preterm Premature rupture of membranes, PPROM, Preterm birth
Simhan HN, Canvan TP. Preterm Premature rupture of
membranes; Diagnosis, evaluation and management strategies.
Denney MJ, Cuhane FJ, Goldenberg LR Prevention of preterm
birth. Women’s Health 2008;4:625–38.
Golden Berg RL, Cuchane JF, Iams J, Romero R. The
epidemiology and etiology of preterm birth. Lancet
Morris JM, Roberts CL, Crowther CA, Buchanan Sl;HendersonSmart DJ, Salkeld G. Protocol for the immediate delivery versus
expectant care of woman with preterm prelaboure rupture of
the membranes close to term (PPROMT) trail. BMC Pregnancy
Smith G, Rafuse C, Anand N, Brenanan B, Connors G, Crane J,
et al. Prevalence , Management and outcomes of preterm
prelabour rupture of the membranes of women in Canada. J
Obstet Gynecol Can 2005;27:547–53.
Tahir S, Aleem M, Aziz R. Incidence and out come of
preterm premature rupture of membranes. Pak J Med Sci
Meis JP, Ernest-JM, Moore ML. Causes of low birth weight in
public and private patients. Am J Obstet Gynaecol
Savitz DA, Blackmore CA, Thorp JM; Epidemiologic
characteristics of preterm delivery: Etiologic heterogeneity. Am J
Obstet Gynaecol 1991;164:467–71.
Lamont R Setting up a preterm prevention clicnic A Practical
guide. BJOG 2006;113(suppl 3):86–92.
Tufail A, Hashmi AH, Naheed F Risk Factors for preterm labour
in a Rural Cohort. Med Channel 2009;15(2):55–7.
Ghazi A, Jabbar S, Siddiq MH. Preterm labour–still a challenge.
Pak J Surg 2006;22:222–6.
Gilbert W. The cost of preterm birth the low cost verses high
value of tocolysis BJOG 2006;113(Supll 3):4–9.
Fahim F, Nisa M. Contribution of preterm delivery to perinatal
mortality. J Postgrad Med Inst 2004;18:275–9.
Charles PJ, Muriel R, Charles PJ, Rene E, Olivien C, Pascal G, et
al. A prospective population based study of 598 causes of PROM
between 24 and 34 weeks gestation description management and
morality (Dominos Cohort). Eur J Obstet Gyreacol Reprod Boil
Kifah AL Qa Qa, Awaysheh FA. Neonatal outcome and Prenatal
Antibiotics Treatment in Premature Rupture of membranes Pak J
Med Science 2005;21:441–4.
Goldenberg RL, Rouse DJ. Prevention of premature birth. N
Engl J Med 1998;339: 313–20.
Seaward PG. International multicenter term PROM study;
evaluation of predicators of neonatal infection in infants born
to patients with PROM at term. Am J Obstet Gyacol
Lewis DF. Antibiotic Therapy in preterm rupture of membranes.
Are seven days necessary? A preliminary randomized clinical
trial. Am J Obstet Gynacol 2003;188:1413–6.