Maternal & Fetal Outcome of Preterm Premature Rupture of the Membranes in Secondary Level Hospital in Bangladesh

Abstract

Background: Premature rupture of membrane (PROM) is linked to significant fetal and maternal morbidity and mortalities. The maternal and fetal outcomes in PROM are very important to decrease maternal and child mortality and for better management and prevention of complications. Objective: To find out maternal & fetal outcomes of preterm premature rupture of the membranes. Methods and Material: This is a cross-sectional observational study carried out in the Department of Obstetrics & Gynaecology, 250 Beded District Hospital, Chapainawabganj, Rajshahi, Bangladesh from January 2016 to July 2016. 50 pregnant women with preterm premature rupture of the membranes. Result: The majority of patients with preterm PROM (30%) belong to the age group 31-35 years. The mean age of the patients and SD were 26.4±6.58. 60% of respondents were multipara and 40% primipara. Most of the patients had irregular antenatal checkups (56%), 24% had regular antenatal checkups, and 20% had no antenatal checkups. Twenty percent of patients developed labor pain within 15 hours of rupture of membrane, 24% within 16-30 hours, 56% within 31-45 hours, 10% within 46-60 hours, and 12% without the onset of labour pain. 37 (74%) patients with preterm PROM had a normal vaginal delivery, and 13(26%) delivered by caesarian Section. Forty-three percent of patients delivered within 24 hours of the ruptured membrane, followed by 24% of patients within 24-48 hours, and 28% of patients within more than 48 hours. Among 50 patients, 12 (24.0%) had a previous history of abortion, 24 (48%) had H/O preterm delivery due to PROM, 2 (4.0%) had H/O MR, and 6 (12.0%) had H/O D & C. Among 50 respondents with PPORM 4 (8.0%) had diabetes mellitus, (12.0%) had HTN, 15 (2.0%) had urinary tract infection and 10 (20.0%) had lower genital tract infection. In this study, the total number of the alive baby was 42, and the stillborn baby was 2. Out of 42 alive babies, 18(42.86%) were affected by the consequence of preterm PROM and the birth process. Among 48 alive babies, 6(12.50%) developed birth asphyxia, 5(10.42%) developed jaundice, 3(6.25%) developed neonatal sepsis, and 4 (8.33%) developed respiratory distress syndrome. Maternal morbidity were chorioamnionitis 4(8%) puerperal sepsis 5(10%), postpartum endometritis 2(4%), abruptio placenta 1(2%) and wound infection 2(4%). Conclusion: The incidence of preterm PROM was more in multipara. The majority of the patients were from lower- and middle-class families. This study found some factors, e.g., Coitus, the recent history of abortion, M.R., D & C, and previous history of PROM. The study was done with a small population, but it introduces us to certain risk factors that can be prevented. Proper health education, patient motivation, improved health hygiene, and adequate maternity and childcare services are needed to reduce morbidity and mortality.