A Clinical Study on Fetomaternal Outcome in Preterm Prelabour Rupture of Membranes

Introduction: Premature rupture of membranes before 37 weeks of gestation is known as preterm premature rupture of membranes (PPROM). PPROM complicates 2% of pregnancies and accounts for 30% of preterm delivery. It is an important cause of perinatal morbidity and mortality. Objectives of the study were to determine incidence, risk factors, maternal and fetal outcome in PPROM cases attending tertiary care hospital in Jhalawar. Methodology: It is a hospital based prospective observational study conducted in the department of obstetrics and gynaecology at Jhalawar Medical College over a period of six months from February 2020 to July 2020. 125 PPROM patients from 24-36+6 weeks of gestation were included in the study and close monitoring of maternal and fetus status was done and followed during the delivery and postnatally. Results: The incidence of PPROM was 3.99%. PPROM was mainly presented in 20-30yrs age group (89.6%), unbooked cases (84.4%) and lower socioeconomic class (64.8%). Mean gestational age was 34.1 weeks. The risk factors like history of abortion (23.2%), history of previous preterm or PPROM (16.7%) in multigravida females, multiple pregnancy (8.8%), polyhydramnios (3.2%), anaemia (93.6%), genital infections (9.6%), UTI (14.4%) and fetal malpresentations (11.2%) were present. 78.4% cases had vaginal delivery and 21.6% underwent LSCS. 16 cases underwent direct LSCS and among rest 55% cases were induced and 45% cases delivered after spontaneous progression. Duration of leaking (greater than24 hrs) was significantly associated with higher NICU admission (p=0.04), low 5-minute APGAR score (pless than0.05) and increased chorioamnionitis occurrence (p=0.003). Maternal morbidity was 5.6%. Perinatal morbidity was 40.8% and neonatal mortality was 12%. Conclusion: Currently, there is no effective way of preventing spontaneous rupture of fetal membranes and the management of PPROM varies according to the gestational age. Therefore, prevention of risk factors like maternal infections and malnourishment during antenatal period may lead to better outcome with regular follow up. Also, timely management to treat PPROM would control neonatal and maternal morbidities.