A prospective observational study on clinical profile and maternal outcome of pregnant women with PROM greater than 28 weeks to onset of labour
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20261621Keywords:
Chorioamnionitis, Lower segment cesarean segment, Preterm rupture of membraneAbstract
Background: Prelabour rupture of membranes (PROM) is a common obstetric condition associated with significant maternal morbidity. This study aimed to study clinical profile, associated etiological factors and maternal outcome in pregnancy with PROM.
Methods: This prospective observational study was done at a tertiary health care centre in south Gujarat. All consenting women with PROM (28 weeks to onset of labour) admitted in labour room of a tertiary health care centre in south Gujarat were enrolled in this study.
Results: Majority of patients belonged to age group of 18-25 years (53.3%). Majority of the patients were from normal BMI (76.3%), literate (62.7%), primigravida (54.7%). The majority of women 66.7% presented with leaking per vaginum, while 33.3% presented with abdominal pain without cervical dilatation with incidental detection of PROM. With respect to gestational age, 58% of pregnancies resulted in term delivery, while 42% resulted in preterm delivery. In our study 69.33% had moderate anemia, 25% had positive high vaginal swab for bacterial vaginosis. 70.3% had poor bishop’s score, 61.3% of our subjects requires induction of labour, 79.7% subjects had leaking to delivery interval was >12 hours. In this study, 54.6 cases underwent LSCS. Most common indication of LSCS was fetal distress (48.8%). Puerperal pyrexia was the most common maternal complication (14.3%), 30.7% of our subjects had lactational failure.
Conclusions: PROM is a significant obstetric condition associated with increased maternal morbidity. Infection-related complications are the major contributors. Early diagnosis, timely antibiotic therapy, and appropriate obstetric management can significantly improve maternal outcomes.
References
Cunningham FG, Leveno KJ, Bloom SL, Dashe JS, Hoffman BL, Casey BM, et al. Williams Obstetrics. 26th ed. New York: McGraw Hill; 2022.
Duff P. Premature rupture of membranes at term. Clin Obstet Gynecol. 1998;41(4):883-91.
American College of Obstetricians and Gynecologists. Practice Bulletin No. 217: prelabor rupture of membranes. Obstet Gynecol. 2020;135(3):e80-97.
Andrabi SU, Ashraf M, Bhat JA, Andrabi SR. Maternal and fetal outcome in PROM. Int J Reprod Contracept Obstet Gynecol. 2019;8(4):1234-8.
Mercer BM. Preterm premature rupture of membranes. Obstet Gynecol. 2003;101(1):178-93.
Goldenberg RL, Culhane JF, Iams JD, Romero R. Epidemiology and causes of preterm birth. Lancet. 2008;371(9606):75-84.
Gibbs RS, Blanco JD. A review of premature rupture of membranes. Obstet Gynecol. 1992;79(5 Pt 1):888-97.
Hannah ME, Ohlsson A, Farine D, Hewson SA, Hodnett ED, Myhr TL, et al. Induction of labor compared with expectant management for prelabor rupture of the membranes at term. N Engl J Med. 1996;334(16):1005-10.
Shrestha SR, Shrestha R, Basnet S, Shrestha B. Fetomaternal outcome in PROM. J Nepal Med Assoc. 2018;56(210):650-4.
Noor S, Fawwad A, Shahzad H, Sultana R, Bashir R. Maternal and neonatal outcomes in PROM. Pak J Med Sci. 2007;23(4):543-6.
Patil S, Patil V, Patil A. Clinical study of PROM and outcomes. Int J Sci Res. 2017;6(8):1210-4.
Lokhande U, Bhole P, Gawande M, et al. Maternal morbidity in PROM. Int J Med Res Rev. 2016;4(5):800-805.
Royal College of Obstetricians and Gynaecologists. Green-top Guideline No. 73. London: RCOG; 2019.
World Health Organization. WHO recommendations on maternal and newborn care. Geneva: World Health Organization; 2020.
Johnson JW, Daikoku NH, Niebyl JR, Johnson TRB, Khouzami VA, Witter FR. Management of PROM. Obstet Gynecol Clin North Am. 1991;18(2):273-88.
Downloads
Published
How to Cite
Issue
Section
