Neonatal and Maternal Outcome after Conservative Management of Preterm Premature Rupture of Membranes (PPROM) between 24-28 Weeks Gestation

Document Type : Original Article

Author

Associate professor Department of Obstetrics and Gynaecology Mansoura University Hospital Mansoura Facult

Abstract

Background:The Incidence of preterm pre mature
rupture of membranes ranges from 3.0-10.0% of all
deliveries and leads to one third of preterm births.
There are several risk factors for PPROM, such as
intrauterine infection at early gestational age, sexually transmitted infections, vaginal bleeding, and
smoking during pregnancy.
Methods: An observational prospective study
included 100 pregnant females with PPROM between the 24th and 28th week’s gestation that were
admitted to Mansoura University Hospital (MUH)
between April 2018 and December 2019. Pregnancies with known fetal malformations, multiple
fetuses, stillbirths, placenta previa, pre-eclampsia
& Eclampsia and diabetes mellitus were excluded
from this study group. Women who deliver within
24 hours of PPROM were also excluded.
Results: Out of 100 pregnant females were eligible for the study only 88 patients continued the
study. Data from our study showed that the median
gestational age at delivery after conservative management of patient diagnosed to have PPROM was
33 weeks. 85.2% of patients delivered by cesarean
section. Recurrent urinary tract infection and Vulvo-vaginitis are the most common associated risk
factors (28 %, 24 %) respectively.The percentage
of live born neonates was (65.9%) while still birth
occurred in (15.9%) and miscarriage occurred in
(18.2%) of the females who completed the study.
The main neonatal complications reported in the
study was 55 out of 58 live birth cases were admitted to NICU (62.5%). Twenty-nine cases developed
respiratory distress syndrome (32.9 %), 17 cases
developed bronchopulmonary dysplasia (19.3%), 6
cases developed pulmonary hypoplasia (6.8%),47
casesdeveloped neonatal sepsis (53.4%) and 34
cases developed perinatal death after admission to
NICU (38.6%). Fourteen neonates were discharged
with different degrees of disability (15.9%). The
overall survived neonates were 24 cases (27.3%).
For maternal complications we noticed that 43 cases developed signs of chorioamnionitis (48.9%).
Also cord prolapse was reported in 3 cases (3.4%).
After delivery postpartum hemorrhage occurred
in 14 cases (15.9%) and 10 cases (11.4%) were in
need of blood transfusion. Signs of maternal sepsis
developed only in 3 cases (3.4%).
Conclusion: Data from our study showed that
after conservative management of patients with
PPROM the overall neonatal survival rate was
27.3 %. 3.4% of neonates were discharged without
need of NICU, 7.95% of neonates were healthy
after being discharged form NICU and 15.9 % of
neonates were discharged with different degrees
of disability. Most of material complication were
not fatal and showed improvement after giving the
appropriate care.

Keywords

Files

Share

How to cite

Statistics