Sidra Tul Muntaha, Dr Sadaf Asma Asma, Dr sara Hayat, Dr Farhan Hassan Muntaha
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 Background: The precise management of obstetrical crisis like preterm premature rupture of membrane is necessary to be designed for an optimum outcome. Both maternal and fetal morbidity and mortality rate can be decreased by accurate approach of clinical management as it is not still established yet. This study was designed to compare the maternal or fetal outcome in conservative management with active management of prelabor premature rupture of membranes at 34 – 37 weeks of gestation. STUDY DESIGN: Randomized control trial SUBJECTS & METHODS: The patient’s data was collected from the department of Gynecology and Obstetrics, F G Polyclinic Hospital and PIMS Islamabad from July 2019 to March 2020. Two groups were made and 90 cases were included in each group on the basis of active or conservative management accordingly. Fetal and maternal morbidity and mortality was judged on the basis of number of fetal distresses, chorioamnionitis and mode of delivery. RESULTS: 180 fetuses, a total of 140 survived. In group A, with conservative management, of the 17 (18.89%) mortalities, 9 (10%) developed fetal infections, 2 (2.22%) delivered prematurely, 3 (3.33%) had RDS. In group B, the active management was observed, 23 (25.55%) babies were expired, 5 (5.55%) contacted infections and died, 9 (10%) were diagnosed to have RDS, 6 (6.66%) deaths were due to prematurity with low birth weight. In conservative management group days of admission was significantly (p-value < 0.05) higher compared to active group. The duration of NICU stay was significantly (p-value < 0.05) higher in active management group (8.88% vs. 15.55%) as compared to conservative group (table 7). The rate of respiratory distress was also significantly (p-value < 0.05) in active management group (5.55% vs. 20%) as compared to conservative group. The mortality rate (25.5%) was bit higher in active management group as compare to (18.89%) in conservative management group but this difference was not statistically significant (p-value >0.05).
 Conclusion: Conservative management of premature preterm rupture of membranes is more appropriate choice of management than active treatment if decided earlier","PeriodicalId":33701,"journal":{"name":"Journal of Islamabad Medical and Dental College","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The Comparison of Fetal and Maternal outcome in Active vs Conservative Management of Prelabor Premature Rupture Of Membranes ( PPROM) at 34 to 37 weeks of gestation.\",\"authors\":\"Sidra Tul Muntaha, Dr Sadaf Asma Asma, Dr sara Hayat, Dr Farhan Hassan Muntaha\",\"doi\":\"10.35787/jimdc.v12i3.958\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"ABSTRACT:
 Background: The precise management of obstetrical crisis like preterm premature rupture of membrane is necessary to be designed for an optimum outcome. Both maternal and fetal morbidity and mortality rate can be decreased by accurate approach of clinical management as it is not still established yet. This study was designed to compare the maternal or fetal outcome in conservative management with active management of prelabor premature rupture of membranes at 34 – 37 weeks of gestation. STUDY DESIGN: Randomized control trial SUBJECTS & METHODS: The patient’s data was collected from the department of Gynecology and Obstetrics, F G Polyclinic Hospital and PIMS Islamabad from July 2019 to March 2020. Two groups were made and 90 cases were included in each group on the basis of active or conservative management accordingly. Fetal and maternal morbidity and mortality was judged on the basis of number of fetal distresses, chorioamnionitis and mode of delivery. RESULTS: 180 fetuses, a total of 140 survived. In group A, with conservative management, of the 17 (18.89%) mortalities, 9 (10%) developed fetal infections, 2 (2.22%) delivered prematurely, 3 (3.33%) had RDS. In group B, the active management was observed, 23 (25.55%) babies were expired, 5 (5.55%) contacted infections and died, 9 (10%) were diagnosed to have RDS, 6 (6.66%) deaths were due to prematurity with low birth weight. In conservative management group days of admission was significantly (p-value < 0.05) higher compared to active group. The duration of NICU stay was significantly (p-value < 0.05) higher in active management group (8.88% vs. 15.55%) as compared to conservative group (table 7). The rate of respiratory distress was also significantly (p-value < 0.05) in active management group (5.55% vs. 20%) as compared to conservative group. The mortality rate (25.5%) was bit higher in active management group as compare to (18.89%) in conservative management group but this difference was not statistically significant (p-value >0.05).
 Conclusion: Conservative management of premature preterm rupture of membranes is more appropriate choice of management than active treatment if decided earlier\",\"PeriodicalId\":33701,\"journal\":{\"name\":\"Journal of Islamabad Medical and Dental College\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-10-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Islamabad Medical and Dental College\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.35787/jimdc.v12i3.958\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Islamabad Medical and Dental College","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.35787/jimdc.v12i3.958","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
文摘:& # x0D;背景:对早产、胎膜早破等产科危象的精确处理是获得最佳结局的必要措施。准确的临床管理方法可以降低孕产妇和胎儿的发病率和死亡率，但尚未建立。本研究的目的是比较在妊娠34 - 37周采用保守治疗和积极治疗的产前胎膜早破的母婴结局。研究设计:随机对照试验受试者;方法:患者数据收集于2019年7月至2020年3月在F G综合医院和伊斯兰堡PIMS妇产科。根据积极或保守治疗方法分为两组，每组90例。胎儿和产妇的发病率和死亡率是根据胎儿窘迫的数量，绒毛膜羊膜炎和分娩方式判断的。结果:180胎，140胎成活。A组采用保守治疗，17例死亡(18.89%)中发生胎儿感染9例(10%)，早产2例(2.22%)，RDS 3例(3.33%)。B组患儿积极管理，死亡23例(25.55%)，接触感染死亡5例(5.55%)，诊断为RDS 9例(10%)，早产低出生体重死亡6例(6.66%)。保守治疗组入院天数显著(p值<0.05)，高于活性组。新生儿重症监护病房住院时间显著(p值<0.05)，积极治疗组呼吸窘迫发生率显著高于保守治疗组(8.88% vs. 15.55%)(表7)。0.05)，与保守组相比，积极管理组(5.55% vs. 20%)。积极治疗组的死亡率(25.5%)略高于保守治疗组(18.89%)，但差异无统计学意义(p值0.05)。结论:如果及早决定，保守治疗比积极治疗更为合适
The Comparison of Fetal and Maternal outcome in Active vs Conservative Management of Prelabor Premature Rupture Of Membranes ( PPROM) at 34 to 37 weeks of gestation.
ABSTRACT:
Background: The precise management of obstetrical crisis like preterm premature rupture of membrane is necessary to be designed for an optimum outcome. Both maternal and fetal morbidity and mortality rate can be decreased by accurate approach of clinical management as it is not still established yet. This study was designed to compare the maternal or fetal outcome in conservative management with active management of prelabor premature rupture of membranes at 34 – 37 weeks of gestation. STUDY DESIGN: Randomized control trial SUBJECTS & METHODS: The patient’s data was collected from the department of Gynecology and Obstetrics, F G Polyclinic Hospital and PIMS Islamabad from July 2019 to March 2020. Two groups were made and 90 cases were included in each group on the basis of active or conservative management accordingly. Fetal and maternal morbidity and mortality was judged on the basis of number of fetal distresses, chorioamnionitis and mode of delivery. RESULTS: 180 fetuses, a total of 140 survived. In group A, with conservative management, of the 17 (18.89%) mortalities, 9 (10%) developed fetal infections, 2 (2.22%) delivered prematurely, 3 (3.33%) had RDS. In group B, the active management was observed, 23 (25.55%) babies were expired, 5 (5.55%) contacted infections and died, 9 (10%) were diagnosed to have RDS, 6 (6.66%) deaths were due to prematurity with low birth weight. In conservative management group days of admission was significantly (p-value < 0.05) higher compared to active group. The duration of NICU stay was significantly (p-value < 0.05) higher in active management group (8.88% vs. 15.55%) as compared to conservative group (table 7). The rate of respiratory distress was also significantly (p-value < 0.05) in active management group (5.55% vs. 20%) as compared to conservative group. The mortality rate (25.5%) was bit higher in active management group as compare to (18.89%) in conservative management group but this difference was not statistically significant (p-value >0.05).
Conclusion: Conservative management of premature preterm rupture of membranes is more appropriate choice of management than active treatment if decided earlier
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