STUDY OF FETO-MATERNAL OUTCOME IN PREMATURE RUPTURE OF MEMBRANES AT TERM PREGNANCY IN A TERTIARY CARE INSTITUTE

• Banhishikha Sircar,  
• namoijam basanti,*  
• Priyanka Nath,  
• Nishant Choudhary,  
• Sinchan Bepde

Abstract

INTRODUCTION: Premature rupture of membranes (PROM) is defined as the spontaneous rupture of membranes before the onset of labor. It is associated with various adverse outcomes including maternal and perinatal morbidity and mortality. Chorio-amnionitis, placental abruption, post-partum hemorrhage, puerperal sepsis, oligohydramnios, cord prolapse, fetal distress, intra-uterine death, perinatal infections are some of the complications associated with it. OBJECTIVE: To evaluate the feto-maternal outcome in PROM. METHODS: It was a prospective cohort study conducted in the Department of Obstetrics and Gynaecology, Regional Institute of Medical Sciences, Imphal, Manipur for one and half years from January, 2021 to June, 2022. A total of 170 pregnant women were included in the study- 85 women with PROM and 85 without PROM. Inclusion criteria includes gestational age of at least 37 completed weeks, lack of uterine contractions for at least one hour after PROM, cervical dilatation less than 3 cm, single live pregnancy in vertex presentation, and PROM confirmed by direct visualization under speculum examination. Exclusion criteria includes mal-presentation, multiple gestation, meconium stained liquor, cephalo-pelvic disproportion. RESULTS: Respiratory distress syndrome was found to be more in babies born to women with PROM, as compared to the babies born to women without PROM, with a relative risk of 1.5. There was no statistically significant association of PROM with neonatal sepsis, NICU admission of new-borns, APGAR score of babies, chorio-amnionitis, or puerperal sepsis. CONCLUSION: This prospective study was carried out to suggest some strategies for proper screening of high-risk cases, correct diagnosis and effective management and thus improvement of maternal and neonatal outcome. Although early diagnosis and proper management can be helpful in decreasing prenatal morbidities in cases of PROM, more randomized controlled trials involving larger sample size is required to draw further conclusions. KEYWORDS: Premature rupture of membranes, chorio-amnionitis, perinatal infections, puerperal sepsis, cord prolapse.

Keywords

Premature rupture of membranes, chorio-amnionitis, perinatal infections, puerperal sepsis, cord prolapse