Fetomaternal Outcomes in Women Affected With Preterm Premature Rupture of Membranes: An Observational Study From a Tertiary Care Center in Eastern India

Abstract

Introduction: Preterm premature rupture of membranes (PPROM) is the spontaneous rupture of the fetal membranes before the completion of 37 weeks of pregnancy. PPROM occurs in 3% of pregnancies. Methodology: This prospective observational study was conducted between September 2019 and March 2021, involving 150 antenatal patients attending our outpatient department or labor room. All pregnant women with a singleton pregnancy between 28 and 37 weeks of gestational age with PPROM were included in our study. Results: A total of 44% of women were admitted to the hospital within 6-11 hours of the onset of PPROM, while 34% of women were admitted within five hours and 15.33% were admitted within 12-23 hours of the onset of PPROM. The most common organisms isolated in high vaginal swabs were Enterococcus faecalis (18%), Escherichia coli (12%), Staphylococcus aureus (12.66%), Staphylococcus haemolyticus (6.66%), and Candida albicans (4.66%). Around 74.66% of women were delivered within 24 hours of the onset of PPROM, whereas only 2.6% of patients were delivered after 72 hours and the rest 34% were delivered between 25 and 72 hours. Of our study subjects, 10% were febrile, 4% were having urinary tract infections, 2.5% had postpartum hemorrhage, and 2% had chorioamnionitis. As far as neonatal morbidity and mortality are concerned, birth asphyxia and jaundice were seen in 12% of patients each, whereas septicemia was found in 4% of study subjects. Conclusion: Owing to the association of higher maternal and perinatal morbidity and mortality, cases, especially in the early PPROM group, should be strictly monitored for clinical and laboratory signs of chorioamnionitis while opting for conservative management.

To study the correlation between severe oligohydramnios with perinatal outcome along with histopathology of placenta

“…66.6 %, had minimal or no antenatal care. Singh N, Pattnaik L [7], in his study, had an incidence of 12 % gestational age at which it was diagnosed was between 34-36 weeks in most of the cases. In our study, about 62 % of cases presented at 34-36 weeks of gestational age.…”

Genomic analysis of Enterococcus faecium strain RAOG174 associated with acute chorioamnionitis carried antibiotic resistance gene: is it time for precise microbiological identification for appropriate antibiotic use?

“…Ncib et al demonstrated that the presence of vaginal-derived Enterococcus spp. is associated with recurrent pregnancy loss [ 52 ], PPROM [ 53 ], and bacterial vaginosis in pregnant women [ 54 ]. Seliga-Siwecka and Kornacka reported that the presence of E. faecalis in amniotic fluid significantly increases the risk for acute placental inflammation, necrotizing enterocolitis, and bronchopulmonary dysplasia in neonates [ 55 , 56 ].…”