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Category: Volume 07 Issue 12 December 2019
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Title: Pprom - Its Prevalence, Predictors, maternal and neonatal outcomes

Authors: Dr Fariha Aman, Dr Samar Mukhtiar, Dr Munaza Aman

 DOI: https://dx.doi.org/10.18535/jmscr/v7i12.50

Abstract

Background: Preterm birth is leading cause of perinatal mortality and morbidity worldwide and account for 75% of neonatal deaths. pprom accounts for 30% of preterm births in world. A prospective study was carried out in kashmirs lalla ded hospital, (which is Valleys biggest tertiary care maternity hospital) With  aim to study  prevalence of preterm premature rupture of membranes &to  identify those women who are at  its increased risk  &  fetal and maternal outcome. Predictors of pprom by patient demographics can improve diagnosis, allow early intervention and hence a reduction in health and economic burden.

Method: A total of 2116 patients were admitted in labour room of Lal Ded hospital from march 2019 to September 2019.out of these patients 382 patients were confirmed to have PPROM. a detailed history was taken, and gestational age confirmed, general, systemic and obstetric examinations were done. all baseline investigations were carried out along with obstetric ultrasound. every patient was followed till her delivery, and the mode of delivery and maternal and fetal outcomes were recorded and data was analysed statically.

Result: In our study prevalence of PPROM was 18%. More common in young age group of 20 to 25 years (56.8%),patient belonging to low socioeconomic status(48.2%), those who were unbooked antenatal cases (52%) & Primigravidas (47.8%). Risk of PPROM was highest in patients who had history of recurrent bacterial vaginosis in their antenatal period.(42%),recurrent bacteriuria (31%), only (24.6%) patients had history of previous pre term deliveries.

In present study 62% cases had normal vaginal delivery, 10% had instrumental delivery and about 28% had LSCS.Fetal distress was  most common indication for LSCS followed by non progression of labor.

Postnatally 18% mothers & 26.8% babies developed infection and needed antibiotics. Majority of babies born were low birth weight babies (72.3%). Perinatal mortality rate was 16% of total births.

Conclusion: PPROM is responsible for considerable maternal morbidity, neonatal morbidity and mortality. The demographic variables with previous antenatal history can help to predict high risk cases so as to screen and treat them beforehand to decrease the prevalence of preterm births and perinatal mortality.

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Corresponding Author

Dr Fariha Aman

Medical officer (Incharge Family Planning Clinic)