Comparison of duration of maternal hospital stay in conservative & aggressive management of Preterm prelabor rupture of membranes(PPROM) in Indian women at 34-36 weeks gestation.

Abstract

Aim:To compare the conservative and aggressive management of Preterm prelabor rupture of membranes (PPROM) in Indian women at 34-36 weeks gestation in terms of duration of their hospital stay. Materials & Method:194 pregnant women with PPROM at gestational age 34-36 weeks admitted in labour ward were included in the study conducted from 2009 -2010 in department of Obstetrics & Gynaecology, SMS Medical College, India. Random allocation to conservative & aggressive management group was done by offering Chit Box Method assigning 97 cases in each group. In conservative management cases were hospitalized& provided bed rest, Daily fetal monitoring, maternal vitals monitoring, Oral tab erythromycin 500 mg t.d.s for 7 days, Daily WBC count and C reactive protein estimation. Expectant management was abandoned if there was clinical evidence of labour, infection or fetal distress. In aggressive management induction of labour was done by Tab Misoprostol 25 g orally, at 4-6 hour intervals, for a maximum of 5 doses. Caesarean delivery was performed for standard obstetrical indication and for failed induction. After delivery neonatal care was provided by neonatologist Results:Out of total 97 cases, in aggressive management, majority 73 (75.26%) cases had duration  5 days, 19 (19.59%) up to 6-10 days and 5 (5.15%) cases up to 11+ days. Similarly out of total 97 cases in conservative management, majority 46 (47.42%) cases had duration  5 days, 33 (34.02%) up to 6-10 days and 18 (18.56%) cases up to 11+ days. The mean duration of hospital stay of mother in aggressive management were 4.10  3.10 days and in conservative management it is 7.21  3.36 days. Conclusion:Majority of cases in both aggressive and conservative management group had duration of hospital stay of  5 days. But the total duration of hospital stay of mother were much higher in conservative management group in present study. Thus mean duration of hospital stay of mother were much higher in conservative management group as compared to aggressive management. Keywords-PPROM, conservative, aggressive, hospital stay.