Study of Maternal and Fetal Outcome Following Term Prelabour Rupture of Membrane in a Peri Urban Tertiary Care Centre

Abstract

Background: Prelabour rupture of membrane at term accounts for 2-10% incidence. It is associated with
significant maternal and fetal complications if not timely managed. Early complications include cord
prolapse, cord compression and placental abruption and delayed complications include chorioamnionitis,
maternal and fetal sepsis. The present study was undertaken to study the labour outcome following active
management of term prelabour rupture of membrane and associated maternal and fetal outcome.
Method: Cases of spontaneous rupture of membranes with singleton pregnancy with gestational age >37
weeks with confirmed PROM by a speculum examination were selected. A detailed history was taken and
gestational age confirmed, general, systemic and obstetric examinations were done. Non stress tests and
blood investigations were sent to rule out sepsis. All patients received prophylactic antibiotics. After taking
consent, induction of labour was done with oral misoprostol and maternal vitals were recorded four hourly
and fetal heart rate was recorded for variability. Induction to delivery interval was recorded and maternal and
fetal outcome following PROM was noted.
Results: PROM was more common in primigravida. Majority of women were admitted within 12 hours
of PROM (87.83%). Recurrent episodes of urinary tract infection was found a significant cause for PROM
(33.78%). Patient delivered vaginally with 55.40%. Post delivery complications included post partum sepsis
in 12.16%. No maternal mortality was noted. Neonatal sepsis was seen in 6 babies (8.10%).
Conclusion: PROM is associated with many maternal and fetal complications which can be reduced by
educating the women to have regular antenatal check up and early recognition of urinary and genital tract
infection, and treat appropriately and to report at the earliest in case of rupture of membrane for timely
management to reduce maternal and fetal morbidities and mortalities.