Study on prevalence of prelabour rupture of membranes and its maternal and fetal outcomes

Abstract

Background: The aim is to study the prevalence of prelabour rupture of the membranes (PROM), to identify risk factors, mode of delivery, and its maternal and fetal effects.Methods: This was a cross-sectional study conducted in the department of obstetrics and gynaecology at Government Head Quarters Hospital, Cuddalore, Tamil Nadu, with a duration of 6months (January 2020 – June 2020). The study was conducted on 800 pregnant women between 28-42 weeks of gestational age consecutively and those who met the inclusion and exclusion criteria were taken into study.Results: The prevalence of PROM was 27.9% (tPROM 24.6% and PPROM 3.2%). Most of the cases were primigravida (74%). Risk factors associated with PROM were low socioeconomic state (63.2%), urinary tract infection (UTI) (7.2%), vaginal infections (5.8%), and previous history of PROM (3.1%). Most of the patients were delivered by lower segment caesarean section (LSCS) (55.2%), normal vaginal delivery (39.9%) and forceps delivery (4.9%). The most common indication for LSCS was fetal distress (43.9%). Misoprostol induction was associated with more failed induction (2 times) than syntocinon. Maternal complications were post-partum haemorrhage (PPH) (8%), fever (6.7%), wound infection (6.2%), manual removal of placenta (4.4%), and puerperal sepsis (0.9%). Neonatal complications were neonatal intensive care unit (NICU) admissions (14%), respiratory distress syndrome (RDS) (11%), neonatal sepsis (2.6%). Maternal (54.5%) and neonatal (90%) morbidity were more in prolonged PROM >24 hours.Conclusions: Antenatal screening for genitourinary infections especially in cases of the previous history of abortions and PROM should be done. Oxytocin is the preferred method of induction over misoprostol in this study. Active management in term PROM cases can reduce the cesarean section rate.