Maternal and Perinatal Outcomes in Preterm Premature Rupture of Membranes (PPROM)

Syed  Nazaneen; Sangeeta  Pankaj; Amrita  Kumari

doi:10.51168/sjhrafrica.v5i12.1465

Authors

Syed Nazaneen MBBS DGO DNB, Department of Gynaecology, Ruban Hospital, Patna, Bihar, India
Sangeeta Pankaj MBBS MS, Department of Gynaecological Oncology, Indira Gandhi Institute of Medical Science, Patna, Bihar, India
Amrita Kumari MBBS MS, Department of Gynaecological Oncology, Ruban Hospital, Patna, Bihar, India

DOI:

https://doi.org/10.51168/sjhrafrica.v5i12.1465

Keywords:

Preterm Premature Rupture Of Membranes, PPROM, Maternal Outcomes, Neonatal Outcomes, Conservative Management, Chorioamnionitis

Abstract

Background: One of the main causes of preterm births and a major contributor to neonatal morbidity and death is preterm premature rupture of membranes (PPROM), which is defined as membrane rupture before 37 weeks of gestation without the commencement of labour. In order to inform clinical therapy, this study is to assess the maternal and perinatal outcomes linked to PPROM and to pinpoint important risk factors influencing these outcomes.

Methods: This prospective multicenter study included 80 pregnant women diagnosed with PPROM. The diagnosis was based on clinical history, sterile speculum examination, and confirmation via ultrasound. Participants, grouped by gestational age at PPROM onset (24–36 weeks), underwent either conservative or active management based on gestational age and clinical condition. Maternal and neonatal outcomes were monitored, including infection rates, latency periods, neonatal APGAR scores, NICU admissions, and complications. Statistical analysis assessed associations between management approaches and outcomes.

Results: Of the 80 participants, 60% experienced maternal complications, with chorioamnionitis (35%) and postpartum hemorrhage (12.5%) being most common. Neonatal complications included low APGAR scores in 23.8% of cases, NICU admissions in 62.5%, and a neonatal mortality rate of 7.5%. Conservative management in patients below 34 weeks led to prolonged latency but increased infection rates, while active management in cases above 34 weeks reduced maternal complications. Key predictors of adverse outcomes were gestational age at PPROM onset, maternal age, and presence of infection.

Conclusion: Gestational age and prompt infection control significantly influence PPROM outcomes. Conservative management is beneficial in extending gestational age but necessitates strict monitoring to prevent infections. Induction in cases above 34 weeks effectively minimizes maternal risks without compromising neonatal outcomes.

Recommendations: For cases <34 weeks, conservative management with vigilant infection monitoring is recommended, while for cases >34 weeks, induction may be beneficial.

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