Preterm premature rupture of membranes: correlates and pregnancy outcome in a tertiary care setting

Authors

  • Reeti Rajan Assistant Professor, Department of Obstetrics and Gynaecology, Dr SMCSI Medical College, Karakonam, Kerala
  • Vrinda Menon Assistant Professor, Department of Obstetrics and Gynaecology, Dr SMCSI Medical College, Karakonam, Kerala

DOI:

https://doi.org/10.18203/2320-6012.ijrms20162285

Keywords:

Fetal outcome, Early neonatal outcome, PPROM, Risk factors

Abstract

Background: Prelabour membrane rupture before 37 weeks of gestation is referred to as preterm premature rupture of membranes (PPROM). Incidence of PPROM is about 2% of all pregnancies. This prospective study aims to determine fetal and early neonatal outcome of pregnancies with PPROM.

Methods: The study was conducted in 190 antenatal women with PPROM between 24 weeks to 36weeks of gestation over a period of 18 months. Their babies were followed up till discharge from Pediatric new born unit.                              

Results: Prevalence of PPROM was 0.8%, accounting for 19% of preterm deliveries. 61% of women with PPROM showed evidence of lower genito-urinary tract infection, 28% had anemia, 48% gave history of coitus during pregnancy. Mean gestational age of membrane rupture was 32 weeks, the mean latency between membrane rupture and delivery was 4.4 days. Chorioamnionitis developed in 13% of women with PPROM, cord prolapse in 4% and abruption in 3%. The gestational age wise survival was 40% in babies weighing less than 1.5kg, 88% in babies weighing 1.5 to 2.5kg and 93% in those more than 2.5kg. The predominant causes of neonatal mortality were hyaline membrane disease (HMD) in babies born before 28 weeks, HMD and sepsis between 29 to 33 weeks and sepsis in babies born after 34 weeks.

Conclusions: Screening and treatment of risk factors may contribute to prevention of PPROM. Neonatal survival depends on gestational age and availability of advanced NICU facilities. Patients and family members should be counseled regarding the outcome of pregnancies with PPROM. A team effort by the obstetrician and neonatologist in a tertiary care setting can ensure a healthy and fruitful life for mother and baby.

 

References

Gibbs RS, Blanco JD. Premature rupture of the membanes. Obstet Gynecol. 1982;60:671-9.

Phupong V, Taneepanichskul S. Outcome of PPROM. J Med Assoc Thai. 2000;83(6):640-5.

Nelson LH, Anderson, Oshea TM. Expectant management of PPROM. Am J Obstet Gynecol. 1994;171(2):350-6.

ACOG practice bulletin no:80. Prelabour rupture of membanes. Clinical management guidelines for obstetrician-gynecologists. Obstet Gynecol. 2007;109(4):1007-19.

Cox SM, Bohman VR, Sherman ML. Randomised investigation of antimicrobials for the prevention of preterm birth.Am J Obstet Gynaecol. 1996;174:206-10.

Ryo E, Ikeya M, Sugimoto M. Clinical study of effectiveness of Imipenem/Cilastatin sodium as antibiotics of first choice in expectant management of patients with PPROM.J infect Chemother. 2005;11(1):32-6.

Phupong V, Taneepanichskul S. Prelabor rupture of membranes. J Paediat obstet Gynecol. 2003;29:25-32.

Hadley C, Main D, Gabbe S. Risk factors for PPROM. Am J Perinat.1990;7:374

Hannah ME, Ohisson CM, Farine D, Hewson SA. Induction of labor compaed with expectant management for prelabor rupture of membranes. N Engl J Med. 1996;334:1005.

Crowley P, Chalmers I, Keirse MJ. The effect of corticosteroid administration before preterm delivery. An overview of evidence from controlled trials. Br J Obstet Gynaecol. 1990;97(1):11-25.

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Published

2017-01-04

How to Cite

Rajan, R., & Menon, V. (2017). Preterm premature rupture of membranes: correlates and pregnancy outcome in a tertiary care setting. International Journal of Research in Medical Sciences, 4(8), 3310–3316. https://doi.org/10.18203/2320-6012.ijrms20162285

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Section

Original Research Articles