PRELABOUR RUPTURE OF MEMBRANES: AN ASSESSMENT OF MATERNAL AND PERINATAL OUTCOMES

Abstract

Despite medical progresses, prelabour rupture of membranes remains one of the leading causes of perinatal morbidity and mortality due to its complications. Thus, a thorough understanding of pathology as well as clinical signs are needed via constant research to get a favorable outcome in terms of maternal as well as foetal outcome. Maternal and foetal outcome may depend on the clinical profile, vaginal swab microbiology or even the blood parameters

Objective: To evaluate and understand various aspects of maternal and foetal outcome of mothers with Prelabour Rupture of Membranes.

Methods: Hospital based observational prospective study

Results:  75% of the mothers included in the study were healthy. Out of the remaining, 15% had puerperal fever, 6.3% had wound infection, 2.5% had PPH and death happened in 1 case (1.2%). A significant statistical difference between those with puerperal fever (p <0.042), PPH (p<0.020) and no complications (p <0.0001) have been found between the two groups (high vaginal swab showing growth as compared to those with no growth.) Birth asphyxia is seen equally in both groups. About neonatal complications, statistically there is significant difference between the two groups in terms of stillbirths (p<0.045), LBW (p<0.043), neonatal death (p<0.034), neonatal sepsis (p<0.045), RDS (p<0.045) and no complications (0.001).

Conclusion: It has been noted in this study that PROM is associated with adverse maternal outcomes such as puerperal fever, wound infection, PPH, maternal death as well as adverse perinatal outcome such as stillbirth, LBW, neonatal sepsis, neonatal death, RDS, MAS, birth asphyxia.

It has also been noted that positive high vaginal swab culture is associated with more incidence of maternal morbidity and neonatal morbidity and mortality.