Clinical study of premature rupture of membranes at term

Abstract

Introduction:The study was undertaken to assess role of different variables such as, presentation in utero, the rupture delivery interval, fetal and maternal outcome in case of PROM at term and their correlation to the rupture delivery interval, also to find out if the results could be improved by change in the attitude towards the condition. Methods: 100 cases of PROM at term admitted at D Y Patil Medical College, Pune, during the period from June 2017 to June 2018 are studied. All single-tone pregnancies with spontaneous rupture of membranes at term gestation>= 37 weeks, demonstration of obvious pooling of amniotic fluid on sterile speculum examination and cervical dilatation < 3 cm and effacement < 80% were included in the study. Results: Maximum of PROM at term cases are with vertex presentation i.e. 88% and remaining 12% having malpresentaions. Total 65% cases delivered vaginally, 13% had vaginal instrumental deliveries and 22% patients had undergone LSCS. There were 8 cases of chorioamnionitis out of that 6 had only fever and remaining 2 had all signs. Total antepartum morbidity was 8%, postpartum morbidity was 8%, neonatal morbidity was 9% and neonatal mortality was 2% in our study. There was no maternal mortality in our study. Conclusion: PROM at term is common phenomenon and can occur in about 8-10% of cases. Incidence of LSCS is more in PROM at term mainly due to associated malpresentaions. Infection being major cause of concern in PROM at term as the maternal as well as neonatal morbidity and mortality increases as the leaking delivery interval (hours) increases.