Maternal and fetal outcome of term pre labour rupture of membrane in a regional referral hospital in Bhutan from 2018-2020: a retrospective cross sectional study

Abstract

Introduction: Term premature or prelabour rupture of membrane (PROM) refers to the disruption in fetal membranes before the onset of labor, after 37 weeks of gestation. PROM is commonly encountered in our practice but there is no published study on PROM in our country. This study was conducted to determine the incidence, clinical profile and it’s association with maternal and fetal outcome in term PROM in our hospital. Methods: A retrospective cross sectional study, carried out at a regional referral hospital in Bhutan. Medical records-based data was collected from clinically diagnosed cases of term PROM, from 1st January 2018 to 31st December 2020. Results: The incidence of term PROM among deliveries was 5.5 %. Unfavourable maternal outcome was seen in Primigravida (p-value=0.05), PROM duration greater than or equal to 24 hours (p-value= 0.007), Prolonged latency period of 24 hours or more (p-value=0.03), prophylactic antibiotics after 18 hours (p-value=0.05) and vaginal delivery (p-value=0.0001). Unfavourable fetal outcome was observed in cases referred in from regional health centres (p-value=0.01). Conclusions: Early initiation of appropriate prophylactic antibiotics, Early induction of labour as opposed to expectant management, Prompt referral of all PROM cases from primary health centres and district hospitals and availability of appropriate prophylactic antibiotics at all health centres may improve maternal and fetal outcome in term PROM.