[Maternal and fetal morbidity in patients with premature rupture of the membrane after 27-week gestation. Causes and costs]. / Condiciones atribuibles y costos de la morbilidad materno-fetal en pacientes con ruptura prematura de membranas después de las 27 semanas de gestación.

Premature rupture of the membranes (PROM) occurs in a third of the childbirths preterm, this represents 8% of all pregnancies, with same morbidity and mortality in developing and developed countries, PROM is the more common cause of neonatal morbidity and mortality, making this obstetric complication a worldwide problem of health, since it contributes to the economic problem for the cost risen in medical attention for both, mothers and live birth. PROM is considered a mutifactorial entity. This study was carried out in the Hospital de Ginecología y Obstetricia of the Centro Médico "La Raza" in Mexico City, where women entered in serial form with pregnancies from 27 to 34 weeks of gestation and spontaneous PROM, without any other pathology. 120 patients were included, with 26.8 +/- 5.9 year-old age. The gestational age with more frequency of PROM were from 30 to 33 weeks, 22.5% of the patients had 4 days with PROM, 6 of this cases arrived up to 13 days with this complication at delivery. 2.5% of the patients presented deciduitis, with adequated response to the use of antibiotics. When analyzing the hospital stay, a stay was observed from 4 to 7 days (5.26 +/- 1.96 M +/- SD), with a total cost for maternal stay of 2 millions 445,650 pesos. Those babies born had an average of 23 days of hospital stay and the total cot of the days of stay was 4 millions 963,978 pesos. Other costs were the attention of maternal and pediatrics specialty, the obstetric resolution of the pregnancy, obstetric ultrasonography and crystallographies. Thus, the total costs of the attention of this complication in these patients with PROM was of 10 millions 296,988 pesos. The international reference is the American dollar that was in 10 pesos for dollar to the moment of this study. The maternal morbidity is low to that described in previous studies, but in spite of the exhaustive efforts on the prevention, prediction, diagnosis and treatment, the premature rate due to PROM has not diminished, however the rate of neonatal survival has been increased and the morbidity has diminished.