scholarly journals Preterm premature rupture of membranes: maternal and perinatal outcome

Author(s):  
Shweta Avinash Khade ◽  
Amarjeet Kaur Bava

Background: This is an observational analytical study carried out in department of obstetrics and Gynecology, in a tertiary care center to determine the factors influencing fetal and maternal outcome, prognosis and complications in preterm premature rupture of membrane cases.Methods: The present study is a prospective observational study of perinatal and maternal outcome in 100 cases of preterm premature rupture of membranes in between 2837 weeks gestation with singleton pregnancy, from 1st March 2013 to 28th February 2014. Patients with medical complications like anemia, preexisting hypertension, diabetes, vascular or renal disease, multiple gestations, uterine or fetal anomalies etc. are excluded from the study. Detailed history, physical examinations were carried out and appropriate management instituted as per individual patients need.Results: In this study maternal morbidity was 16%. Perinatal morbidity was 33% and most common causes were hyperbilirubinemia (23%), RDS (21%).  Perinatal mortality was seen in 15% and mainly due to RDS (53%). Twenty-five (25%) neonates were delivered by cesarean. The main indications for cesarean being malpresentation (36%) followed by fetal distress (24%).Conclusions: PPROM is one of the important causes of preterm birth that can result in high perinatal morbidity and mortality along with maternal morbidity. Looking after a premature infant puts immense burden on the family, economy and health care resources of the country. An understanding of gestational age dependent neonatal morbidity and mortality is important in determining the potential benefits of conservative management of preterm PROM at any gestation.

2021 ◽  
pp. 11-14
Author(s):  
Madhuri Rani ◽  
Kumudini Jha ◽  
Debarshi Jana

Background: Preterm premature rupture of membranes (PPROM) occurs in 3%to6% of pregnancies and is responsible for approximately one third of all preterm births. Aims & Objective: of present study was to analyse the maternal and perinatal outcome of PPROM patients between 28 to 36 weeks +6days admitted in labour room of obs and gynae dept. of DMCH from January 2019 to April 2020. Material and Methods: It is hospital based prospective observational study of 100 patients of preterm premature rupture of membranes in between 28-36 weeks+6 days gestation with singleton pregnancy admitted in our tertiary care centre (Department of Obstetrics and Gynaecology, DMCH, Laheriasarai, Bihar). Results: In this study 42% patients went into spontaneous labour and 58% needed induction or augmentation. 68% patients had vaginal delivery and 23% required LSCS. The main indications for LSCS being malpresentation (26%) followed by foetal distress (22%). There was no maternal mortality; morbidity was found in 15% patients. Perinatal morbidity was seen in 40% and was mainly due to RDS, sepsis andhyperbilirubinaemia . Perinatal mortality was seen in 17% and was due to sepsis in 29.4%, RDS in 52.94% and birth asphyxia in 17.6%. Conclusion: PPROM is one of the important causes of preterm birth that can result in high perinatal morbidity & mortality along with maternal morbidity. Looking after a premature infant puts immense burden on the family, economy and health care resources of the country. Therefore management of PPROM requires accurate diagnosis and evaluation of the risks and benets of continued pregnancy or expeditious delivery. An understanding of gestational age dependent neonatal morbidity and mortality is important in determining the potential benets of conservative management of preterm PROM at any gestation


Author(s):  
Sailaja Surayapalem ◽  
Vijayalakshmi Cooly ◽  
Bhuvaneswari Salicheemala

Background: Premature rupture of membranes is defined as rupture of foetal membranes before the onset of labour. Management of cases of PROM still remains as one of the most difficult and controversial problems in obstetrics. PROM can cause maternal complications like chorioamnionitis, increased operative procedures, puerperal sepsis and neonatal morbidity and mortality. The present study is undertaken to study the labour outcome, maternal morbidity and perinatal morbidity and mortality in term PROM.Methods: 200 Cases of spontaneous rupture of membranes with gestational age >37 weeks with confirmed PROM by a speculum examination were selected. A detailed history was taken, and gestational age confirmed, general, systemic and obstetric examinations were done. Parameters of maternal and foetal well being were recorded. All study groups received prophylactic antibiotics. Single pelvic examination done, and maternal vitals recorded fourth hourly. All the data was analyzed and statistical significance was calculated using Chi-square test.Results: PROM was common in age group of 20-24 years (35%) with mean age of 22.6 years and SD of 2.8 years, and common in primigravida. Majority of women were admitted within six hours of PROM (41.5%) and Mean duration of induction to delivery interval was 12.9 hours. The mean duration between PROM to delivery was 20.2 hours which was statistically significant. Cesarean sections were more among primigravidas. Failure to progress was the common indication. Maternal morbidity was significant (17.5%). No maternal mortality in the study. Perinatal mortality was 1.5%. Birth asphyxia was the commonest cause. Perinatal morbidity was seen in 26%. Escherichia coli was common organism found in cervical swab culture.Conclusions: In present study, majority was primigravidas and the most common age group was 20-24 years belonging to low socioeconomic status. Maternal morbidity and neonatal morbidity was associated with increased duration of PROM to delivery and infection of the female genital tract with pathogens. Hence an appropriate and accurate diagnosis of PROM is essential for favorable outcome in pregnancy.


Author(s):  
Patil S. A. ◽  
Gaikwad B. H. ◽  
Purohit P. ◽  
Chintan Upadhyay

Background: PROM is associated with increased risk of chorioamnionitis, unfavorable cervix and dysfunctional labour, increased cesarean rates, postpartum hemorrhage and endometritis in the mother. Possible neonatal outcomes in cases of PROM may include respiratory distress syndrome, hypothermia, hypoglycemia, intraventricular hemorrhage, broncho pulmonary dysplasia etc. Objective of this study the maternal and perinatal outcomes in premature rupture of membranes at term.Methods: This prospective study was done among 100 pregnant women with premature rupture of membranes after 37 completed weeks visited at department of obstetrics & Gynecology in RCSM Hospital, Kolhapur during June 2014 and June 2015. Inclusion Criteria was Gestational  age  of  >37  weeks  confirmed  by  dates,  clinical  examination  or ultrasound, cervical dilatation of <3 cms, Lack of uterine contractions for atleast 1 hour from PROM, Single live pregnancy in vertex presentation and PROM confirmed by Direct visualization or Litmus.Results: Present study found highest number of cases among age group 20-24 years and mean age was 22 years. Almost 70% cases were un-booked. Average duration to PROM to hospital admission was 9.6 hours. Most common maternal outcome was febrile illness Most common perinatal outcome was birth asphyxia and 3 perinatal death.Conclusions: Pregnancies complicated with PROM should have supervised labor preferably in an institution. Management of each case has to be individualised. A combined effort of obstetrician and neonatalogist is necessary. A good neonatal intensive care unit can be instrumental in reducing the perinatal morbidity and mortality.


2021 ◽  
Vol 10 (16) ◽  
pp. 3631
Author(s):  
Yolanda Cuñarro-López ◽  
Santiago García-Tizón Larroca ◽  
Pilar Pintado-Recarte ◽  
Concepción Hernández-Martín ◽  
Pilar Prats-Rodríguez ◽  
...  

Coronavirus disease-19 (COVID-19) is perhaps the most worrisome pandemic in the 21st century, having entailed devastating consequences for the whole society during the last year. Different studies have displayed an existing association between pregnancy and COVID-19 severity due to the various physiological changes that occur during gestation. Recent data identified maternal country of origin as an important determinant of COVID-19 presentation in pregnant women. However, the explanation of this fact remains to be fully elucidated. Therefore, the purpose of this work is to analyze the possible relationship between Human Development Index (HDI) of maternal country of origin with the morbimortality of pregnant women and their newborns. Here, we conducted a multicentric, ambispective, observational case-control study (1:1 ratio) and compare with the HDI of each country (group 1—very high HDI, group 2—high HDI, group 3—medium HDI, and group 4—low HDI). In total, 1347 pregnant women with confirmed SARV-CoV-2 infection (cases) were enrolled, and each was paired with one control to give a total number of 2694 participants from 81 tertiary care centers. Among the women with SARS-CoV-2 infection, more cases were produced of perinatal mortality, overall maternal morbidity, COVID-19 maternal morbidity, C-sections, hypertensive maternal morbidity, and perinatal morbidity. Our results described an inverse association between HDI and maternofetal morbidity and mortality. Moreover, the countries with an HDI lower than 1 showed higher rates of patients with maternal COVID-19-related morbidity (6.0% vs. 2.4%, p < 0.001), a need for oxygen therapy (4.7% vs. 1.8%, p < 0.001), and maternal ICU admission (2.6% vs. 1.0%, p = 0.007). Compared to other risk factors such as overweight, obesity, preexisting and obstetric comorbidities, HDI emerged as an independent risk factor explaining much of the increased maternal–perinatal morbidity and mortality detected in our group of cases. Further research is needed to establish to confirm the real impact of this factor and its components on pregnancy outcomes.


Author(s):  
Anita G. Pawar ◽  
Mangala A. Shinde ◽  
Sarasjothi M. ◽  
Priyanka B. Nemagouda

Background: Obstetric hysterectomy (OH) is indicated as last resort operation to save the life of the mother  and associated with high complication rates, so  requires a highly experienced and skilled medical team ,to solve any complication. Objective was to identify incidence, demographic profile, indications, risk factors, complications, maternal morbidity and mortality associated   with   obstetric hysterectomy.Methods: Retrospective   analytical study of 47 case records is done over period of last 5 years   from October 1st October 2015 to 30th September 2020 at VDGIMS, a tertiary care center, Latur. Results are expressed in frequency and percentages.Results: In our study, the rate of OH was 1.1/1000 deliveries. Most common (68%) age group was 21-30 yrs, majority (70%) were multipara, and booked (76%). Most common indication of OH was atonic PPH (65%), followed by traumatic PP, including rupture uterus (21%), and placenta acreta (10%). Most OH was performed on emergency basis (91%) and of subtotal type (95%). Major mode of delivery  was cesarean 65% and vaginal delivery in 21% cases. Most common risk factors were placental causes (55%), previous LSCS (48%) and hypertensive disorder (31%). High maternal morbidity in form of 100% blood transfusion rate, 93% ICU admission, inotropes and ventilator support in 59% cases and prolonged hospital stay in 75% cases seen. Most common complication were hemorrhagic shock 21%, DIC (29%), renal failure (12%) and septic shock (14%) with maternal death rate of 23% was noted.Conclusions: Obstetric hysterectomy is a necessary life-saving operation, but also associated with high maternal morbidity and mortality, which can be minimized with timely done procedure by experienced person.


2019 ◽  
Vol 19 (3) ◽  
Author(s):  
Mohd. Andalas ◽  
Cut Rika Maharani ◽  
Evans Rizqan Hendrawan ◽  
Muhammad Reva Florean ◽  
Zulfahmi Zulfahmi

Abstrak. Ketuban Pecah Dini (KPD) atau Premature rupture of Membranes (PROM) merupakan pecahnya ketuban yang terjadi sebelum proses persalinan. Ketuban pecah dini terjadi sekitar 1% dari seluruh kehamilan. Ketuban pecah dini menyebabkan terjadinya 1/3 persalinan preterm dan merupakan penyebab 18%-20% dari morbiditas dan mortalitas perinatal. Dalam laporan kasus ini kami melaporkan seorang ibu hamil berusia 35 tahun, gravida 3, hamil aterm dengan ketuban pecah dini, keluhan keluar air dari jalan lahir dan belum inpartu. Laporan kasus ini bertujuan untuk meningkatkan kualitas diagnosa dini serta penatalaksanaan ketuban pecah dini untuk mengurangi risiko bagi ibu dan janin. Abstract.Premature Rupture of Membranes (PROM) is the rupture of amniotic sac prior to the onset of labor beyond 37 week of gestation. Premature Rupture of Membranes occurs in 1% ofall pregnancies. Premature Rupture of Membranes causes 1/3 preterm delivery and a major  18%-20% cause of perinatal morbidity and mortality. In this case report we reported a 35 year old woman with pregnant 3rd child, aterm wiht Premateur rupture of Membrane (PROM) and prior to labor. This report aims to improve the quality of early diagnosis and management of premature rupture of membranes to reduce the risk for the mother and fetus. 


Author(s):  
Poovathi M. ◽  
Yogalaksmi Yogalaksmi

Background: Preterm premature rupture of membranes is defined as rupture of fetal membrane before onset of labour at less than 37 completed weeks of gestation and after 28 weeks of gestation. Incidence ranges from 3-10% of all deliveries. Preterm premature rupture of membrane is one of the important causes of preterm birth can result inhigh perinatal morbidity and mortality. Preterm premature rupture of membranes complicates 3% of pregnancies and leads to one third of preterm birth. Preterm delivery affects one in 10 birth in USA and even greater birth in developing continues and causes 40-75% neonatal death. There are numerous risk factors for preterm premature rupture of membrane such as maternal, socioeconomic class, infection at early gestational age and associated co-morbid condition. Both mother and fetus are at greater risk of infection after preterm premature rupture of membrane.The fetal and neonatal morbidity and mortality risks are significantly affected by severity of oligohydrominos, duration of latency and gestation at preterm premature rupture of membrane. The objective is to study perinatal outcome in preterm premature rupture of membrane.Methods: This is a prospective study conducted in Mahathma Gandhi Memorial Government Hospital attached to K. A. P. V. Government Medical College, Trichy, Tamil Nadu, India. This is a tertiary health centre. This study has been conducted from January 2018 to June 2018.Results: Incidence of PPROM ranges from 3.0-10.0% of all deliveries. PPROM complicates approximately 3% of pregnancies and leads to one third of preterm birth.Conclusions: In present study most of newborn had better 5min Apgar especially late preterm group. In present study RDS was common in early preterm group and hyper bilirubinaemia common in late preterm group. In current study most of patients delivered vaginally compared to 36% of LSCS.


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