Fetomaternal outcomes in conservative management of preterm premature rupture of membrane
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20210328Keywords:
Chorioamnionitis, Conservative management, Fetomaternal outcome, Preterm PROMAbstract
Background: The management of PPROM remains controversial. Aim of this study was to determine the fetomaternal outcome in conservative management of PPROM.
Methods: A prospective observational study was done on a total of 110 pregnant women between 24 and 36 weeks 6 days gestation with PPROM visiting Geetanjali medical college and hospital from February 2019 to July 2020. All the patients were subjected to detailed history and examination and followed till their delivery.
Results: The incidence of PPROM in our study was 4.94%. The mean latency period from membrane rupture to delivery decreased from 12.1±14 days at >28 weeks, 5.3±7.7 days at 28-31 weeks 6 days to 1.1±1.2 days at 32 to 36 weeks 6 days. The most common indication of LSCS was fetal distress (26.31%). E. coli was the most common organism (36.36%) isolated and it was significantly associated with gestational age at PPROM (p value <0.040405). The maternal morbidity was 24.53% and was closely associated with the gestational age at PPROM (p value <0.001). The perinatal morbidity was 44.20% and perinatal mortality was 13.04% which was mainly due to RDS (33.34%).
Conclusions: Management of PPROM involves complete evaluation of risks and benefits of conservative management. The treatment should be directed toward conserving the pregnancy with prophylactic use of antibiotics and corticosteroids thereby reducing fetomaternal morbidity and mortality. However, termination of pregnancy should be considered at the earliest suspicion of chorioamnionitis, septicaemia.
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