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

Abstract

Background : Premature Rupture of Membrane (PROM) is one of the most common complication of pregnancy. A woman with premature rupture of membrane is at risk of perinatal morbidity and mortality and also associated with maternal morbidity and psychological stress. Objective of this study was to determine incidence and risk factors of pregnant woman with PROM admitted in a tertiary hospital at Chattogram, Bangladesh.
 Materials and methods : This prospective observational study conducted in the Department of Obstetrics and Gynaecology at Chattogram Maa-O-Shishu Hospital Medical College (CMOSHMC) Chattogram from 1stJanuary 2018 to 31st December 2018. In this period total admitted antenatal patients were 8117. Among the pregnant patients with PROM were 665 and their weeks of gestation were > 28 weeks. Data was collected by interviewer with semi structured questionnaire & check list.
 Results : Incidence of PROM was 8.2%. PROM was found to be frequent (53%) in younger age group between 20-24 years. It was also commonly in primigravida (61.8%). Term PROM was higher (69.2%) than pre-term PROM (30.8%). 93.3% were singleton pregnancies, 6.4% were twins and .3% were triplets. Analysis of risk factors revealed ectiology was unknown in 46 (6.8%) low socioeconomic condition (60.6%), anaemia (45 %), lower genital tract infection (35.6%) UTI (31%) previous history of PROM (27.9%) malpresentation (15%) multiple pregnancy (6.7%) polyhydramnios (6%) history of recent coitus (12%) DM and GDM (10.5%) were commonly associated with PROM.
 Conclusions : Early identification of various risk factors causing PROM and their management can prevent premature deliveries and its complications to some extent as well as serious maternal complication like Chorioamnionitis.
 Chatt Maa Shi Hosp Med Coll J; Vol.19 (2); July 2020; Page 5-8

Determinants of term premature rupture of membrane: case-control study in Saint Paul’s Millennium Medical College Hospital, Addis Ababa, Ethiopia

“…This study found that pregnant women with a history of PROM have a 9.955 times greater likelihood of developing PROM than those whose mothers did not. In agreement with our findings, other studies conducted in Ethiopia, America, and Nigeria found the impact of a history of PROM on subsequent pregnancy [ 4 – 9 ].…”

Prelabour Rupture of Membranes among Pregnant Women Visiting a Tertiary Care Centre: A Descriptive Cross-sectional Study

“…In the study conducted in Bangladesh, the study of factors revealed aetiology was unknown in 46 (6.8%), low socioeconomic condition 60.6%, anaemia 45%, lower genital tract infection 35.6%, UTI 31%, previous history of PROM 27.9%, malpresentation 15%, multiple pregnancies 6.7%, polyhydramnios 6%, history of recent coitus 12%, DM and GDM 10.5% were commonly associated with PROM. 7 In consistency, our study also revealed twin pregnancy 2 (6.7%) and malpresentation 4 (7.14%) in the index pregnancy.…”

“… 6 This is also similar to a study done in Bangladesh with the prevalence of PROM of 8.2%. 7 Term PROM was higher 39 (69.2%) than preterm PROM 17 (30.8%). Similarly, a study done in India reported prevalence as 9.8%.…”

Perinatal Outcome in Premature Rupture of Membranes (PROM) and Pre-Prom (PPROM)

“…Additional morbidities include more caesarean sections and instrumental deliveries due to fetal distress, maternal pyrexia, sepsis or coordinated uterine activity. 10,11 In order to prevent maternal complications and fetal mortality, pre-labour membrane rupture is the most common cause of morbidity and requires prompt diagnosis and treatment. This study aimed to know the maternal and fetal outcomes in PROM and PRE-while patients with a known case of placenta previa, previously more than one cesarean section, known case of chorioamnionitis, preeclampsia and eclampsia were excluded from this study.…”