Maternal and fetal outcome of prelabor rupture of membranes at term expectant management

This descriptive study was carried out to analyze the maternal and fetal outcome of 24 hours expectant management`: in patients of PROM at term. 100 women presenting with prelabor rupture of membranes at term were included. All the patients were managed conservatively for 24 hours, followed by induction if labor did not start spontaneously, or if signs of chorioamnionitis developed at any stage. Magnitude of PROM during the year 2002 was` 7.008%. Spontaneous labor rate with in 24 hours was 84%. 2% patients developed signs of chorioamnionitis in less than 24 hours and 14% patient did not enter into spontaneous labor after 24 hours of PROM. 94% patients with PROM delivered vaginally while 6 caesarian sections were carried out. Postnatal complications were observed in 17% of patients. These included chorioamnionitis 2%, PPH 7%, puerperal pyrexia 4%, wound infection 3%, and DVT in 1% patient. Mean Apgar score of babies was 5.90, 1 min after birth and 8.7, 5 min after birth. Maximum babies had APGAR score of 9 at 5 min after birth, 8 babies were admitted to ICU and only 1 baby developed proven neonatal infection. This study shows that conservative management is safe with excellent maternal and neonatal outcome.

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Induction of Labor Versus Expectant Management for Prelabor Rupture of Membranes

50 Studies Every Obstetrician-Gynecologist Should Know ◽

10.1093/med/9780190947088.003.0014 ◽

2021 ◽

pp. 74-80

Author(s):

Adina Kern-Goldberger ◽

Dena Goffman

Keyword(s):

Cesarean Section ◽

Lower Risk ◽

Expectant Management ◽

Neonatal Infection ◽

Induction Of Labor ◽

Prostaglandin E ◽

Maternal Infection ◽

Prelabor Rupture Of Membranes

The article highlights a landmark paper from 1992 addressing the management of women with prelabor rupture of membranes at term. The article reviews the paper in detail, highlights similar and relevant subsequent studies, and addresses up-to-date guidelines. The study compared the outcomes of 5041 with prelabor rupture of membranes at term. Women were either induced with oxytocin or vaginal prostaglandin or expectant management with subsequent induction as indicated. In women with prelabor rupture of the membranes at term, induction of labor with oxytocin or prostaglandin E2 and expectant management result in similar rates of neonatal infection and cesarean section. Induction of labor with intravenous oxytocin results in a lower risk of maternal infection than does expectant management. Women view induction of labor more positively than expectant management.

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Impact of Maternal Obesity on Perinatal Outcomes in Preterm Prelabor Rupture of Membranes ≥34 Weeks

American Journal of Perinatology ◽

10.1055/s-0039-1698833 ◽

2019 ◽

Vol 37 (05) ◽

pp. 467-474 ◽

Cited By ~ 2

Author(s):

Tara A. Lynch ◽

Amol Malshe ◽

Sarah Colihan ◽

Jeffrey Meyers ◽

Dongmei Li ◽

...

Keyword(s):

Maternal Obesity ◽

Neonatal Outcome ◽

Univariate Analysis ◽

Mode Of Delivery ◽

Perinatal Outcomes ◽

Expectant Management ◽

Respiratory Support ◽

Antibiotic Administration ◽

Significant Difference ◽

Prelabor Rupture Of Membranes

Abstract Objective This study aimed to compare pregnancy outcomes in obese and nonobese women with preterm prelabor rupture of membranes (PPROM) ≥34 weeks. Study Design The present study is a secondary analysis of a multicenter retrospective cohort of singletons with PPROM from 2011 to 2017. Women with a delivery body mass index (BMI) ≥30 kg/m2 (obese) were compared with women with a BMI < 30 kg/m2 (nonobese). Pregnancies were stratified based on delivery policies of expectant management until 35 weeks versus immediate delivery ≥34 weeks. The primary outcome was a composite neonatal outcome (neonatal sepsis, antibiotic administration for duration >72 hours after delivery or respiratory support). Univariate analysis and general estimating equations models including maternal age, delivery timing, mode of delivery, hospital, and gestational age were used with p < 0.05 level of significance. Results Among 259 pregnancies, 47% were obese. Pregnant women with obesity had increased composite neonatal outcome versus nonobese pregnancies (adjusted odds ratio [aOR] = 1.48 [95% confidence interval (CI): 1.01–2.17]). Obesity was also associated with increased neonatal antibiotic administration for a duration >72 hours after delivery, respiratory support, ventilation, oxygen supplementation, and surfactant administration. When stratified by delivery policies there was no significant difference in perinatal outcomes based on obesity. Conclusion Obese women with PPROM ≥34 weeks have an increased odds of adverse neonatal respiratory and infectious outcomes compared with nonobese women.

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Fetal outcome of pre-labor rupture of membranes

Nepal Journal of Obstetrics and Gynaecology ◽

10.3126/njog.v1i2.1489 ◽

1970 ◽

Vol 1 (2) ◽

pp. 19-24 ◽

Cited By ~ 3

Author(s):

Sita Ram Shrestha ◽

Paban Sharma

Keyword(s):

Risk Factors ◽

Pregnant Women ◽

Neonatal Morbidity ◽

Neonatal Infection ◽

Fetal Outcome ◽

Time Interval ◽

Normal Delivery ◽

Study Results ◽

Prelabor Rupture Of Membranes ◽

Control Study

Objective: To study the determinants and outcome of prelabour rupture of membrane at term pregnancy in Patan Hospital. Method: A prospective, hospital based case control study done in maternity ward of Patan Hospital over the period of three months (Poush 2059-Phalgun 2059). A total no of 100 pregnant women with prelabor rupture of membrane and 100 pregnant women without prelabor rupture of membrane were included in this study. Results: The incidence of pre labor rupture of membrane in this study was 6.06%. Major risk factors for prelabor rupture of membranes were antecedent coitus, hydramnious, smoking, cephalo-pelvic disproportion, and previous abortion. Normal delivery occurred in 70% in prelabor rupture of membrane group and in 93 % in non-prelabor rupture of membrane group. Forty-nine pregnant women with pre-labour rupture of membrane received antibiotics and twenty-four babies (48.98%) developed neonatal infection in pre-labour rupture of membrane group and only one developed infection in non-prelabour rupture. Four cases of neonatal infection was seen in neonates born from mothers with prelabor rupture of membranes < 24 hours and 20 cases of neonatal infection were seen in those neonates born from mother with pre-labor rupture of membrane >24 hours (p < 0.05). Conclusion: Neonatal morbidity increases with the increase of time interval between the rupture of membrane and delivery and antibiotics given to mother of PROM does not totally protect neonates from infection. Keywords: Pre labor rupture of membrane, major risk factors for pre-labor rupture of membranes, neonatal infection doi:10.3126/njog.v1i2.1489 N. J. Obstet. Gynaecol Vol. 1, No. 2, p. 19 -24 Nov-Dec 2006

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A RANDOMIZED COMPARATIVE STUDY OF PROGRESS OF LABOUR AND FETAL OUTCOME OF DELIVERY AMONGST SPONTANEOUS VERSUS INDUCED LABOUR IN TERM PREGNANCY PRIMI GRAVIDA OF USING MODIFIED WHO PARTOGRAPH IN THE DEPARTMENT OF OBSTETRICS AND GYNECOLOGY SMS MEDICAL COLLEG

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v3i12.806 ◽

2019 ◽

Vol 3 (12) ◽

Author(s):

Yeshwant Singh Chouhan ◽

Anju Sharma ◽

Megha Agrawal

Keyword(s):

Apgar Score ◽

Uterine Contraction ◽

Neonatal Outcome ◽

Perinatal Outcomes ◽

Fetal Outcome ◽

Labour Induction ◽

Intrauterine Death ◽

Cross Sectional ◽

Weight Category ◽

Significant Difference

Background: Childbirth is the period from the onset of regular uterine contraction until expulsion of placenta. The process by which this normally occurs is called labour. Induction of labour is the artificial initiation of uterine contraction prior to their spontaneous onset, leading to progressive dilatation and effacement of the cervix and delivery of the baby. Labour induction is indicated where the benefits to either the mother or the fetus outweighs the benefit of continuing pregnancy. Methods: Hospital based Prospective type of cross sectional study conducted at Department of Obstetrics and Gynaecology, S.M.S Medical College, Jaipur, Rajasthan. We assessed the following perinatal outcomes: at 1st and 5th minute APGAR score; birth weight; birth injuries; respiratory distress syndrome; admission to the NICU; number of days in NICU; neonatal deaths taking place in hospital within the first week of life; stillbirth or intrauterine death. Results: The highest percentage of babies were in the weight category of 2500 to 3499 grams in both groups, 83.3% in spontaneous and 76.7% in induced group, followed by ≥3500 gram and <2500 gram respectively. There is no statistical significant difference in weight of babies between the groups (P=0.64). In induced group ≤7 APGAR Score at 1 minute is 1.1%, and 7.8% in spontaneous group. There is statistically significant increase in Spontaneous group (P < 0.05). In induced group ≤7 Apgar score at 5 minutes is 0%, and 5.6% in spontaneous group. ≤7 APGAR score at 5minutes is significantly higher in Spontaneous group (P < 0.05). 3.3% of Induced group babies needed Admission to NICU compared to 2.2% in Spontaneous group, there is no statistically significant difference between groups (P = 0.684) Conclusion: We conclude from this study that though requirement of Augmentation for progress of Labour was more in induced group and Instrumentation rate of Caesarean section was also high in induced group. But the Neonatal outcome of Labour if monitored with modified WHO Partograph is less than Spontaneous group and also duration of labour is shorter in induced labour. Keywords: WHO Partograph, Induction, Neonatal outcome.

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MECONIUM STAINED LIQUOR;

The Professional Medical Journal ◽

10.29309/tpmj/2013.20.02.652 ◽

2013 ◽

Vol 20 (02) ◽

pp. 202-207

Author(s):

IRAM ASLAM,

Keyword(s):

Risk Factor ◽

Amniotic Fluid ◽

Vocal Cord ◽

Apgar Score ◽

Neonatal Outcome ◽

Perinatal Death ◽

Descriptive Study ◽

Memorial Hospital ◽

Apgar Scores ◽

Speculum Examination

The Presence of meconium in amniotic fluid is a risk factor for intrapartum hypoxia. It had been considered as an indicatorof poor neonatal outcome. Objective: To determine neonatal outcome in meconium stained liquor. Design: Descriptive Study. Setting:Department of Gynae and Obstetrics, Fatima Memorial Hospital, Lahore. Period: 06 months from 21-01-2009 to 20-07-2009. Subjectsand Methods: The patients with meconium stained liquor were assessed by per speculum examination and were followed till the time ofdelivery. Neonatal outcome was assessed by APGAR scores at 1 minute, vocal cord staining, admission to ICU Nursery, perinatal death,need of resuscitation and total stay in ICU Nursery. Results and Conclusion: During the study period, 140 patients were included in study.Among these, 97 babies had APGAR score < 5 at 1 minute, 102 babies had staining of vocal cord while 119 babies were admitted to ICUNursery. Incidence of perinatal death was 8.6%. Conclusions: Meconium stained liquor is associated with poor neonatal outcome.

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A descriptive study to assess the maternal and fetal outcome among women with preeclampsia at selected tertiary care hospital, bangalore.karnataka

International Journal of Pharma and Bio Sciences ◽

10.22376/ijpbs.2018.9.3.b82-86 ◽

2018 ◽

Vol 9 (3) ◽

Author(s):

C. SANGEETHA ◽

DR. PRASANNA BAB ◽

DR. BALAKRISHNA NAI

Keyword(s):

Tertiary Care Hospital ◽

Tertiary Care ◽

Descriptive Study ◽

Fetal Outcome ◽

Care Hospital

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Neonatal Survivability following Previable PPROM after Hospital Readmission for Intervention

American Journal of Perinatology Reports ◽

10.1055/s-0040-1721421 ◽

2020 ◽

Vol 10 (04) ◽

pp. e395-e402

Author(s):

Felicia LeMoine ◽

Robert C. Moore ◽

Andrew Chapple ◽

Ferney A. Moore ◽

Elizabeth Sutton

Keyword(s):

Gestational Age ◽

Neonatal Intensive Care ◽

Intensive Care Unit Discharge ◽

Expectant Management ◽

Antibiotic Administration ◽

Tertiary Referral Center ◽

Membrane Rupture ◽

South Central ◽

Prelabor Rupture Of Membranes ◽

Latency Duration

Abstract Objective To describe our hospital's experience following expectant management of previable preterm prelabor rupture of membranes (pPPROM). Study Design Retrospective review of neonatal survival and maternal and neonatal outcomes of pPPROM cases between 2012 and 2019 at a tertiary referral center in South Central Louisiana. Regression analyses were performed to identify predictors of neonatal survival. Results Of 81 cases of pPPROM prior to 23 weeks gestational age (WGA), 23 survived to neonatal intensive care unit discharge (28.3%) with gestational age at rupture ranging from 180/7 to 226/7 WGA. Increased latency (adjusted odds ratio [aOR] = 1.30, 95% confidence interval [CI] = 1.11, 1.52) and increased gestational age at rupture (aOR = 1.62, 95% CI = 1.19, 2.21) increased the probability of neonatal survival. Antibiotics prior to delivery were associated with increased latency duration (adjusted hazard ratio = 0.55, 95% CI = 0.42, 0.74). Conclusion Neonatal survival rate following pPPROM was 28.3%. Later gestational age at membrane rupture and increased latency periods are associated with increased neonatal survivability. Antibiotic administration following pPPROM increased latency duration.

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