Outcome of Premature Rupture of Membranes – A Study of 120 Cases in Dhaka Medical College Hospital

Abstract

Introduction: Premature rupture of membrane or PROM means when membrane ruptures before the onset of labour at a gestational age less than 37 completed weeks. In Bangladesh, every year, around 28,000 women die due to complications of pregnancy and childbirth. Nonscientific intervention in PROM made at various levels intensify the pregnancy complications several times, thereby leading many more deaths of foetus and newborn. Aetiology of PROM is largely unknown. The possible causes are either reduction of membrane strength or an increase in intrauterine pressure or both. Proper diagnostic facilities, proper monitoring and standard protocol in the management can improve the maternal and fetal outcome.Aim and objective: The aim of the study was to observe the incidence, type and maternal and fetal outcome of PROM.Materials and Method: A prospective case control analytical study was carried out at Dhaka Medical College Hospital, Dhaka from May ‘2000 to December‘2000. Total 120 patients were selected for this study among them 60 patients as case (Group A) and 60 patients were taken as control (Group B). Both primi and multigravida with Pregnancy more than 28 weeks with intact membrane as control and spontaneous rupture of membrane taken as case. High- risk patients such as hypertensive disorder of pregnancy, APH, cardiac disease, previous H/O caesarean section were excluded from the study. After taking proper history, speculum examination, some diagnostic investigations were carried out. Findings were recorded in predesigned questionnaire and statistical analysis were done using computerized software SPSS for Windows. A P value < 0.05 was taken as significant.Results: In our study maternal complications were significantly higher in Group A patients (Chi-square test: X2 = 6.263, df= 1, P< 0.05). Number of premature babies in PROM patients (25%) was significantly higher than control group. Perinatal morbidity was found higher in PROM (36.66%) compared to control group (31.66%). Most common morbidity was neonatal jaundice in PROM patients (13.33%) compared to babies of control group (8.33%).Conclusion: This study focused on certain risk factors in relation to PROM which can be preventable and reduce incidence and improvement of maternal and fetal outcome.J Dhaka Medical College, Vol. 25, No.2, October, 2016, Page 82-86

Risk Factors of Premature Rupture of Membrane in A Tertiary Care Hospital, Bangladesh

“…Another important risk factor of PROM is urinary tract infection which was 31% in our study and almost similar to the study done by another private tertiary care hospital and Begum A et al where prevalence were 31.8% and 33.33% respectively 11,4 . Anaemia, hypertension and diabetes are associated risk factors of PPROM by affecting nutrition and immunity of the patient produce PROM 14,15 .…”

“…In the study done by Begum N, low socioeconomic status was 50% 7 . In present study maximum (61.8%) cases with PROM were primigravida which was almost similar (62.7%) and (53.33%) to the study done by lovereen S et al and Begum A et al respectively 12,4 . According to Akhter et al chance of increase sexual activity and increased genital infection are the most common among primigravida and in their study primigravida were 53% 13 .…”

“…In our study incidence of PROM was 8.2%, of which term PROM 5.7% and preterm PROM 2.5%. Begum A et al, Choudhary M et al and Nazneen S et al in their study showed hospital incidence of PROM 9.05%, 9.8% and 6.3% respectively which were close to our study [4][5][6] . Another study done by Begum N reported an incidence of 9.04%.…”

“…But almost similar rate (8.12%) was reported in a study done by Tasnim S 7,8 . Majority (53%) of the patients belonged to the age group 20-24 years which is similar to the studies done by Begum A et al, Nazneen S et al and Tasnim S 4,6,8 . Most of the patient's (73.7%) were housewife which was higher than the study showed by Assefa N et al which was 58.8% 9 .…”

Maternal and Fetal Outcome of Preterm Prelabor Rupture of the Membranes in a Tertiary Care Hospital

“…Proper diagnostic facilities, proper monitoring facilities and a standard protocol in the management can improve the maternal and fetal outcome. 15 This study was a cross sectional study which was done to evaluate maternal and fetal outcomes of preterm PROM in tertiary medical college hospital of Bangladesh.…”