Background: PROM occurs in approximately 10 % of all pregnancies and in 70% of the cases at term. Although there is some morbidity when PROM occurs in term pregnancies, the fundamental clinical problem is preterm PROM, a condition that occurs in 3% of all pregnancies and is responsible for approximately 30 % of all preterm deliveries. Preterm PROM complicates 3-8% of pregnancies and leads to one-third of preterm deliveries. It increases the risk of prematurity and leads to other perinatal and neonatal complications, with a 1- 2% risk of fetal death. PROM is associated with increased risk of chorioamnionitis, dysfunctional labor, increased cesarean rates, postpartum hemorrhage, and endometriosis in the mother. In the fetus, there is increased occurrence of hyaline membrane disease, intra ventricular hemorrhage, sepsis, cord prolapse, fetal distress, and increased fetal wastage. Thus, the earlier the gestational age at the time of PROM, the longer the latency and the more complications. Management of PROM remains controversial and challenging. Controversy surrounds the role of tocolytics, steroids, and antibiotics. The aim of the study was to observe the maternal and perinatal outcome in patients with preterm premature rupture of membranes; to study the maternal complications in preterm premature rupture of membranes; to find out the perinatal morbidity and mortality in preterm premature rupture of membranes, and to study the mode of delivery in preterm premature rupture of membranes. So study of maternal and perinatal outcome in cases of PPROM is likely to yield valuable information regarding severe morbidity which could lead to death of the mother and fetus if not diagnosed early and treated in time. This prospective study will help to improve the quality of obstetric care.
Methods: The present study is an institution based prospective observational study of perinatal and maternal outcome in 100 cases of preterm premature rupture of membranes in between 28-37 weeks gestation with singleton pregnancy, from 1st March 2021 to 28th February 2022. Patients with medical complications like anemia, preexisting hypertension, diabetes, vascular or renal disease, multiple gestations, uterine or fetal anomalies etc. are excluded from the study. Detailed history, physical examinations were carried out and appropriate management instituted as per individual patients need.
Results: PPROM occurs more frequently in primi gravida (58%) compared to that of multigravida. Risk factors unknown factors 67% while the most common risk factor among others was found to be breech presentation (13%), and 59% of the study population had vaginal delivery while 32% of the patients delivered through LSCS and 9% of them had assisted breech mode of delivery. Out of all LSCS, Fetal distress was found to be the most common indication for LSCS in the present study, which accounted for 37.5%. 53% of the population, had delivery within 24 hours. Out of 100 cases studied, 31% of the babies born to PPROM mothers were admitted in NICU. Out of 31% of the babies admitted in NICU, the most common cause for neonatal morbidity was respiratory distress syndrome (14%), followed by jaundice (9%), septicemia (5%), IVH (3%). Perinatal mortality was 3% which was due to RDS.
Conclusion: The most common cause of perinatal mortality in early PPROM is prematurity and its complications. Hence conservative management to prolong pregnancy is recommended under strict monitoring for evidence of chorioamnionitis. C-reactive protein helps to pick up chorioamnionitis early. At the earliest evidence of chorioamnionitis termination irrespective of gestational age is warranted. In late PPROM, perinatal outcome is good. So, termination is advised as conservative management shall add to the fetal and maternal morbidity due to sepsis.
Keywords: Preterm Premature Rupture of Membranes (PPROM), Prematurity, Chorioamnionitis, Respiratory Distress Syndrome (RDS), Fetal Distress.
How to cite this article: Majumdar I, Mondal SC, Maternal And Perinatal Outcome In Cases Of Preterm Premature Rupture Of Membrane - A Prospective Observational Study. Int J Drug Deliv Technol. 2026;16(4s): 738-749; DOI: 10.25258/ijddt.16.4s.86
Source of support: Nil
Conflict of interest: None