Comparison of Fetomaternal Outcome in Women With Preterm Premature Rupture of Membranes on Expectant Management Versus Delivery at 34 Weeks

Abstract

Abstract Purpose To study feto-maternal outcomes in women with preterm prelabour rupture of membranes (PTPROM) on expectant management versus delivery at 34weeks of gestation and correlate period of latency and inflammatory markers with delivery outcomes. We have chosen this research topic as there is paucity of specific guidelines regarding the optimal period of gestation for delivering women with PTPROM. Methods Prospective observational study conducted on 262 women with PTPROM from 28–33 + 6weeks of gestation. Women were monitored till 37weeks with biweekly total leukocyte count (TLC) and weekly C reactive protein (CRP), urine routine microscopy (URM), urine culture, high vaginal culture (HVS) sensitivity and ultrasound. Women were monitored expectantly till 37 weeks however intervention was done at any time during feto-maternal compromise. Feto-maternal outcomes were documented. Result Amongst the study group 238 (90.8%) women were managed expectantly while 24 (9.1%) required intervention. A latency of 3-4weeks was observed in 131(50%) women. Chorioamnionitis developed in 13(4.9%) and 5.7% neonates developed sepsis however both had no correlation with the latency period. Neonates who developed sepsis (5.7%) were comparable in both the groups (p = 1.000). Early neonatal death (END) occurred in 10 (3.8%) amongst which seven died because of Low birth weight (LBW), two due to sepsis and one due to respiratory distress. LBW was significantly associated with END(p < 0.001). Conclusion Expectant management beyond 34 weeks with close monitoring can improve the neonatal outcomes without increasing maternal morbidity in women with PTPROM.