Analysis of factors increasing the risk of prelabour rupture of membranes and its effect on fetomaternal outcome

Abstract

Perinatal morbidity and mortality due to prelabour rupture of membranesPROM) is 18-20% and 21.4% respectively. Multiple risk factors are associated with the development of PROM. Limited data is available on the risk factors of term PROM and relation of its duration with adverse maternal and fetal outcomes from India. To assessfactors increasing the risk of PROM and effect of duration of rupture of membranes on fetomaternal outcome. Five hundred and ten patients presented with term PROM in the Department of Obstetrics and Gynaecology, Sultania Zanana Hospital, Gandhi Medical College, Bhopal, Madhya Pradesh (M.P.) from December 2018 to February 2019 were studied. After the detailed history, sociodemographic details, risk factors for PROM and neonatal outcomes were recorded. PROM was more common in women with age 21-25years (73.3%), who were housewife (92.5%), were underweight (21.37%), were from the rural area (58.4%), belong to lower SES (62.8%) and were primigravida (59.2%). Majority were leaking for 13-24 hours (70.2%). Majority (85.64%) of patients had spontaneous onset of labour in less than 24 hours of PROM and 28(14.35%) went into spontaneous labour after 24 hours of PROM. Most common risk factor was malpresentation (46.52%) followed by history of PROM (30.04%), Polyhydramnios (13.19%), multiple pregnancy (10.99%) and febrile illness (6.96%). Out of 312 women who had vaginal delivery, labour was induced in 87.82% women. The most common indication for Caesarean section was previous 1 LSCS (13.1%), followed by fetal distress (8.6%), breech presentation (7.3%) and cephalopelvic disproportion (2.9%). Most of the women presenting with PROM were delivered vaginally (61.2%), while 38.8% women underwent caesarean section. Out of 529 babies, 6.24% were admitted in NICU. Majority of the neonates were admitted for 3 days (39.39%). PROM is associated with poor fetomaternal outcome and timely diagnosis and prompt management is required for better outcome.