Review of Feto-Maternal Outcome in Patients with Premature Rupture of Membranes at Term

Abstract

Background: Premature rupture of membranes complicates 5 to 10 % of the singleton pregnancies and is a major contributor of maternal morbidity and neonatal morbidity and mortality in terms of sepsis and prematurity, even in the today's era of antibiotics. Most of these complications can be prevented provided timely, targeted management is initiated.Objectives: To provide a comprehensive understanding of the fetal and maternal outcome with premature rupture of membranes at term, for a better management.Material and Methods: This descriptive Cross Sectional study was conducted in department of Obstetrics and Gynecology HMC, from 15th of September 2022 till 15th of February 2023. Random sampling method was adopted in this study and a total of 241 patients presented with spontaneous rupture of membranes after 37 weeks till 41 weeks. A detail history, physical and gynecological examination was performed, and all the information gathered from the patient by the doctors was then recorded on a pre-designed proforma.Results: Out of 241 patients of PROM 60 cases of maternal and 145 cases of fetal complications were observed. As per maternal outcomes, 28(46.7%) patients had wound infection,16(26.6%) patients developed oligohydramnios, 07 (11.7%) patients were recorded with Puerperal Pyrexia secondary to endometritis, and 09 (15%) patients developed chorio-amnionitis. About 56% of the mothers had cesearen deliveries. As per fetal outcomes, 78(53.8%) cases were recorded with RDS, 35(24.1) with hyperbilirubinemia, 23 (16%) babies developed neonatal sepsis, and 09(6.2%) had necrotizing Enterocolitis. Conclusion: Premature Rupture of Membrane at term has a risk of both fetal and maternal complications. Prolonging pregnancy as in conservative management adds to the fetal and maternal morbidity more in terms of sepsis. In this study, we concluded that conservative management to prolong pregnancy carry risk both for mother and baby and is recommended only under strict monitoring.Keywords: Chorioamnionitis, Latency period, Maternal outcome, Perinatal outcome, Sepsis.