Original Articles
A study on Fetomaternal Outcome in term Premature Rupture of Membrane | |
Dr. Selvi, Dr. Dilsath Begam, Dr. Vennila | |
Introduction- Premature rupture of membrane (PROM) is defined as the spontaneous rupture of amniotic membrane along with the leakage of amniotic fluid before the onset of true labour pain anytime after 28 weeks of gestation. This is an unpredictable condition associated with increased maternal /perinatal morbidity and mortality if not timely managed. Aims and objectives-To analyse and understand the outcomes in term pregnancy with PROM regarding the mode of induction , development of chorioamnionitis, puerperal sepsis, endometritis, PPH and interventions like operative deliveries / cesarean section. To analyse the perinatal outcome in term PROM cases. Material and methods - It is a prospective study conducted in Department of Obstetrics and Gynecology, Government Vellore Medical College. This study consists of an analysis of labour outcome in 200 cases presented with PROM after 37completed weeks in one year. The datas were collected and analysed. The descriptive statistics in terms of mean and proportion and inferential statistics by Chi square test, Fischer exact tests. Results- In this study, term PROM occurred in 61.5% of cases in the age group of 18 - 23years. Most cases of PROM were booked cases (70.5%). PROM occured in low SES of about 66.5% while it's incidence in middle SES is 29.5%. It's incidence in primi is about 69.5%(133) while in multigravida accounts for about 33.5%(67) . Most commonly PROM occurred in gestational age between 38 -39 weeks . In this study risk factors were assessed which included, GHTN (24.5%), anemia(15%) and polyhydromnis. While Assessing these risk factors causing PROM, 50% of the study population had no risk factors. We received PROM 5% cases with duration of PROM less than 12hours and 89.5% PROM cases with duration of greater than 12hours , 5.5% greater than 24hours. About 69%(138) delivered by labour natural , 28%(56) delivered by Emergency LSCS and 3%(6) got delivered by instrumentations.. Hence labour natural being most common mode of delivery in our study. Among cervical swab culture sensitivity reports Only 33% of the cases were found to have growth in amniotic fluid culture, most common organism is E .coli (19%) . Maternal complications occurred in about 18 cases (9%) . It's incidence occured in group with duration of PROM greater than 24hours . Most common complications being Puerperal pyrexia and wound infection , which were treated with iv antibiotics. 20% of the infants born to PROM mothers had NICU admission for different complications. Out of which only 13 (6.5%) neonatal deaths occurred. In majority of cases neonatal death occurred due to RDS following septicemia. Conclusion-All women advised to have regular antenatal care and advise about diet, nutrition and personal hygiene should be given.Genital tract infection should be identified early and treated. Team approach, early recognition of prelabour rupture of membranes and their associated complication and appropriate management of situation helps in reducing the problems caused by PROM to a great extent. |
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