A study of fetal outcome in patients with premature rupture of membranes with gestational age more than 28 weeks

Background: Premature rupture of membranes is rupture of membranes before the onset of labour irrespective of gestational age. If it occurs before 37 weeks, it is called as preterm premature rupture of membranes (PPROM). Once PROM delivery is inevitable, so neonatal prognosis depends on gestational age at which PROM occurs. Neonatal complications include prematurity and its complications mainly, also pulmonary hypoplasia due to severe oligohydramnios, skeletal and joint deformities to foetus due to compression, increased risk of neurodevelopmental impairment and neonatal white matter damage. PROM is a still one of the most difficult and controversial problems in obstetrics.Methods: A prospective longitudinal study was conducted in Department of Obstetrics and Gynaecology at a tertiary care hospital from 2021 to 2023 (18 months). A total of 275 patients admitted with complaints of per vaginal leaking with gestational age more than 28 weeks were studied. A multivariate analysis was used to find association between PROM and foetal outcome.Results: In this study, 57% (157) new-borns had birth weight >2.5 kgs, 60% (166) new-borns had APGAR score 8/10, 71% (196) new-borns were term, 40% (109) had NICU stay, 6% (17) had respiratory distress syndrome (RDS), 3% (8) had neonatal sepsis, 2% (6) had neonatal hypoglycaemia and perinatal mortality rate was 1% (3).Conclusions: Once there is PROM, delivery is imminent. Neonatal outcome can be improved significantly after administration of steroids and antibiotics. To get that time short term tocolysis can be used. During that time foeto-maternal monitoring should be done for early detection of chorioamnionitis. Looking after preterm infants puts an immense pressure on family, economy and health care resources. The prevention of PROM is difficult so more focus should be on management of PROM.