A study on management of premature rupture of membranes
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20180412Keywords:
Labor, Management, Membranes, Premature, RuptureAbstract
Background: Premature rupture of membranes (PROM) is a common obstetric complication. Knowledge of etiopathogenesis, diagnosis, complications and management of PROM has significantly increased due to extensive research in the recent past. Yet, there is no unanimous opinion regarding optimum management of PROM. The aim of the study was to observe the patients during labor and compare the latent period, duration of first stage of labor, modes of deliveries and the use of oxytocin and its outcome in PROM cases with controls. The study has been conducted with the belief that these data will help in better management of PROM cases in future.
Methods: In this study, the definition of PROM adopted is rupture of fetal membranes before the onset of true labor pain. The minimum gestational age was taken to be 28 weeks. Diagnosis of PROM was mainly clinical. Patients were monitored during the latent period and during labor. Induction of labor was done where necessary. Collected data were analysed using Chi Square Test.
Results: It was observed that onset of labor was more rapid with increasing gestational age. Use of oxytocin for induction and augmentation of labor and operative deliveries were higher in PROM cases. These results mostly corroborated with the findings of other researchers.
Conclusions: The conclusion drawn at the end of the study was that individualized management of PROM cases depending on the gestational age and risk of complications is the best way to achieve a good fetomaternal outcome.Metrics
References
McParland PC, Taylor DJ, Bell SC. Mapping of zones of altered morphology and choriodeciduaic connective tissue cellular phenotype in human fetal membranes (amnion and deciduas) overlying the lower uterine pole and cervix before labor at term. Am J Obstet Gynecol. 2003Nov;189(5):1481-8.
Lebherz TB, Hellman LP, Madding R, Anctil A, Arje SL. Double-blind study of premature rupture of the membranes. A report of 1896 cases. Am J Obstet Gynecol. 1963 Sep;87(2):218-25.
Sacks M, Baker TH. Spontaneous premature rupture of the membranes. A prospective study. Am J Obstet Gynecol. 1967 Apr;97(7):888-93.
Conway DI, Prendiville WJ, Morris A, Speller DCE, Stirrat GM. Management of spontaneous rupture of the membranes in the absence of labor in primigravid women at term. Am J Obstet Gynecol. 1984 Dec 15;150(8):947-51.
Raut MD, Dora H. PROM- A clinical and bacteriological study. J Obstet Gynaecol India. 1988;38:554-62.
Cammu H, Verlaenen H, Perde MP. Premature rupture of membranes at term in nulliparous women: a hazard?. Obstet Gynecol. 1990 Oct;76(4):671-4.
Donnelly JF, Flowers CE, Creadick RM, Greenberg BG, Wells HB. Parental, fetal, and environmental factors in perinatal mortality. Am J Obstet Gynecol. 1957 Dec;74(6):1245-56.
Sanyal MK, Mukherjee TN. Premature rupture of membranes an assessment from a rural medical college of West Bengal. J Obstet Gynaecol India. 1990;40(5):623-8.
Schreiber J, Benedetti T. Conservative management of preterm premature rupture of the fetal membranes in a low socioeconomic population. Am J Obstet Gynecol. 1980 Jan;136(1):92-6.
Spinnato JA, Shaver DC, Bray EM, Lipshitz J. Preterm premature rupture of the membranes with fetal pulmonary maturity present: A prospective study. Obstet Gynecol. 1987 Dec;25(6):489.
Egan D, O’hlerlihy C. Expectant management of spontaneous rupture of membranes at term. J Obstet Gynaecol. 1988 Jan;8(3):243-7.
Chua S, Arulkumaran S, Karup A, Anandakumar C, Tay D, Ratnam SS. Does prostaglandin confer significant advantage over oxytocin infusion for nulliparas with prelabor rupture of membranes at term? Obstet Gynecol. 1991 May;77:664-7.
Shalev E, Peleg D, Eliyahu S, Nahum Z. Comparison of 12-and 72-hour expectant management of premature rupture of membranes in term pregnancies. Obstet Gynecol. 1995 May;85(5 Pt 1):766-8.
Ladfors L, Mattson LA, Eriksson M, Fall O. A randomized trial of two expectant managements of prelabor rupture of the membranes at 34 to 42 weeks. Br J Obstet Gynaecol. 1996 Aug;103(8):755-62.
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. TERM PROM Study Group. N Engl J Med. 1996 Apr 18;334(16):1005-10.
Calkins LA. Premature spontaneous rupture of the membranes. Am J Obstet Gynecol. 1952 Oct;64(4):871-7.
Theobald GW, Kelsey HA, Muirhead JMB. The pitocin drip. J Obstet Gynaecol Br Emp. 1956 Oct;63(5):641-62.
Russell KP, Anderson GV. The aggressive management of ruptured membranes. Am J Obstet Gynecol. 1962 Apr;83(7):930-7.
Gunn GC, Mishell DR Jr, Morton DG. Premature rupture of the fetal membranes. A review. Am J Obstet Gynecol. 1970 Feb;106(3):469-83.