Cases Of Preterm Premature Rupture Research Articles

Outcomes after extended azithromycin administration in preterm premature rupture of membranes

Preterm premature rupture of membranes accounts for approximately one-quarter of all preterm deliveries and occurs in 2% to 3% of all pregnancies. With subclinical infection being a suspected cause of preterm premature rupture of membranes, the administration of prophylactic antibiotics is an accepted standard of care to extend the latency period. Historically, erythromycin was used in the antibiotic regimen recommended for women with preterm premature rupture of membranes during expectant management; however, azithromycin has recently been shown to be a suitable alternative. This study aimed to evaluate whether extended azithromycin administration affects the latency time in preterm premature rupture of membranes. This was a retrospective multi-institutional cohort study in Washington, District of Columbia, of patients admitted from January 2012 to December 2019 with preterm premature rupture of membranes of singleton pregnancies between 23 0/7 and 33 6/7 weeks of gestation. Patients were excluded if they had multiple pregnancies, had an allergy to penicillin or macrolides, were in labor, had suspected placental abruptions, had overt chorioamnionitis, or had nonreassuring fetal status on presentation indicating the need for prompt delivery. Patients that received limited azithromycin administration (<2 days) and patients that received extended azithromycin administration (7 days) were compared. All patients otherwise received the institutional standard of 2 days of intravenous ampicillin followed by 5 days of oral amoxicillin. The primary outcome was length of gestational latency, defined as the time from membrane rupture to delivery. The selective secondary outcomes that were evaluated were rates of chorioamnionitis and adverse neonatal outcomes, including sepsis, respiratory distress, necrotizing enterocolitis, intraventricular hemorrhage, and neonatal death. During the study period, 416 cases of preterm premature rupture of membranes were identified. Of the 287 patients who met the inclusion criteria, 165 (57.5%) received limited azithromycin administration, and 122 (42.5%) received extended azithromycin administration. Adjusted median gestational latency was significantly longer for patients who received extended azithromycin administration, extended by >3 days (2.6 days [interquartile range, 2.2-3.1] for limited azithromycin administration vs 5.8 days [interquartile range, 4.8-6.9] for extended azithromycin administration; P<.001). Neonatal secondary outcome evaluation was performed on 216 cases (76%). There was no difference in chorioamnionitis or adverse neonatal outcomes between the 2 groups. Among patients with preterm premature rupture of membranes, extended azithromycin administration was associated with increased latency, without any effect on other maternal or neonatal outcomes.

Myasthenia gravis and pregnancy: retrospective evaluation of 27 pregnancies in a tertiary center and comparison with previous studies.

To share our experience with the management of pregnancies in women with myasthenia gravis (MG) in a tertiary center. The study retrospectively evaluated 27 pregnancies in 12 patients. The pregnancies were divided into 3 groups on the basis of the clinical course of MG during pregnancy: improvement (n = 7), disease-stable (n = 9), and deterioration (n = 11). The groups were compared with respect to patient characteristics, clinical features, and obstetric outcomes. There were 4 miscarriages (14.8%), 3 preterm births (11.1%), and 4 cases of preterm premature rupture of the membranes (PPROM) (14.8%). Exacerbation was observed in 25.9% of the cases; the remission rate during the postpartum period and after miscarriage was 37%. The cesarean section (CS) rate was 78.3%. Pregnancies with deterioration of MG were statistically more likely to have higher miscarriage, preterm birth, PPROM, CS, and transient neonatal MG rates, in addition to a lower gestational age at birth, birth weight, and 5-min Apgar score than pregnancies with improved or stable disease (p values < 0.001, 0.04, 0.03, 0.009, 0.02, < 0.001, 0.002, and 0.043, respectively). Physicians who manage pregnant women with MG must be familiar with the clinical features of the condition; a multidisciplinary approach is necessary for a better prognosis.

Blood routine test is a good indicator for predicting premature rupture of membranes

To assess the value of blood routine test (blood RT) in order to predict the occurrence of premature rupture of membranes (PROM). A retrospective study was conducted to collect blood RT data from 100 cases of preterm premature rupture of membranes (pPROM), 70 cases of full-term premature rupture of membranes (fPROM), and 100 cases of full-term pregnancy (Normal). Nonparametric tests were performed for each blood routine parameter, the ROC curve was established for the parameters with significant difference, and the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratios (+LR), and negative likelihood ratios (-LR) were further calculated. The statistical results showed that WBC, NE.%, LY.%, EO.%, BA.%, NE.#, EO.#, RBC, HGB, HCT, and NLR were significantly different between pPROM and fPROM (P<0.05). There was a significant difference in WBC, NE.%, LY.%, NE.#, MO.#, RBC, HGB, HCT, and NLR between the pPROM and Normal groups (P<0.05). Between the fPROM and Normal groups, only WBC was statistically significant (P<0.05). By establishing ROC curve, the results showed that when the cutoff value of WBC was 9.63 and NEU# was 7.12, their combined detection had the best predictive value with a sensitivity of 73% and a specificity of 81%. In addition, Its PPV was 79.3%, NPV was 75%, +LR was 3.84, and -LR was 0.33. The patient's blood RT results can be used to predict the risk of premature rupture of membranes, and in order to improve the sensitivity and specificity, multiple parameters can be combined.

Radiofrequency Ablation in Complicated Monochorionic Pregnancy: Initial Experience

AbstractTo evaluate outcomes of complicated monochorionic pregnancies intervened by radiofrequency ablation (RFA) and report the initial experience. It is a retrospective case series of 15 cases of complicated monochorionic twin pregnancies intervened by RFA in Mediscan Systems Chennai, a tertiary referral Fetal Medicine center, from February 2015 till February 2017. Perinatal outcomes were available for all 15 cases. Main indication for RFA was sIUGR in 10 cases, of which 2 had coexistent Twin to Twin Transfusion syndrome. The procedure was technically successful in all cases. Median gestational age at procedure was 22.6 weeks (IQR 21, 25.6). The median number of RFA cycles to attain cardiac asystole was 4 (IQR 3, 7). Four of the fifteen cases (27%) had procedure related complications of which 3 occured within 2 weeks of procedure. There were 2 cases of preterm premature rupture of membranes which occurred within 2 weeks of procedure. One case had a miscarriage within 2 weeks of procedure at 21 weeks, another one had a mid-trimester loss 4 weeks after the procedure at 26 weeks. The median gestational age at delivery was 35 weeks (IQR 29.3, 35.5). Seventy-eight percent of the live borns were delivered after 34 weeks. The median procedure delivery interval was 10.4 weeks (IQR 4.1, 13.6). Median birth weight at delivery was 2000 g (IQR 1300, 2600). The present series had a live birth rate of 87%. In this initial small series, there was a good outcome in terms of live birth rates and take home baby rates. The efficacy needs to be ascertained by larger series and long term neurological outcome.

Oncologic and obstetric outcomes and complications during pregnancy after fertility-sparing abdominal trachelectomy for cervical cancer: a retrospective review.

Trachelectomy was developed as a fertility-sparing surgery for early-stage cervical cancer in patients of childbearing age. The purpose of this study is to evaluate oncologic and obstetric outcomes and complications after abdominal trachelectomy. We began to perform abdominal trachelectomy in 2005. Our institutional review board approved this clinical study, and fully informed consent was obtained from each patient. The medical records of patients who underwent trachelectomy were retrospectively reviewed. We performed 151 abdominal trachelectomies (89 radical trachelectomies, 48 modified radical trachelectomies, and 14 simple trachelectomies). The median age of the patients was 33years, and the median postoperative follow-up period was 61months. Although one patient experienced recurrence at the preserved cervix, none died after treatment. A total of 61 patients attempted to conceive after trachelectomy, and 21 pregnancies were achieved in 15 women. Hence, the pregnancy rate among patients who attempted to conceive was 25%. Fifteen babies were delivered by cesarean section between gestational weeks 23 and 37. Six babies were delivered at term. Six cases of preterm premature rupture of the membranes occurred. Varices appeared around the uterovaginal anastomotic site in five patients. Our data indicate that the oncologic outcome was excellent but infertility treatment was necessary to achieve the majority of conceptions. Additionally, preterm premature rupture of the membranes and premature delivery were frequently observed. An improved pregnancy rate and prevention of complications during pregnancy are issues that should be addressed in future studies.

182 Cases of Premature Rupture of Membranes and Treatment Strategy Analysis

&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Related factors and treatment strategies of premature rupture of membranes (PROM) were discussed. &lt;strong&gt;Method: &lt;/strong&gt;Retrospective analysis of 182 cases of preterm premature rupture of membranes (PPROM) from Yanshan County Hospital from January 2010 to October 2015. &lt;strong&gt;Results&lt;/strong&gt;&lt;strong&gt;: &lt;/strong&gt;From the 182 cases [123 vaginal delivery and 59 cesarean section (C-section)], there were 79.12% PROM cases were detected in the presence of risk factors. Neonatal mortality and complications were significantly higher at 28−33 + 6 weeks of pregnancy than those at 34−36 + 6 weeks, 28−33 + 6 weeks, and 34−36 + 6 weeks. &lt;strong&gt;Conclusion: &lt;/strong&gt;In order to improve the survival rate of newborns, the related factors leading to PPROM should be treated.&lt;/p&gt;

Placental abruption and premature rupture of membranes

To assess whether premature rupture of membranes (PROM) is associated with placental abruption. Population-based study. Data were extracted from the Medical Birth Registry of Norway. All women with PROM (18,889 cases), including 3,077 cases of preterm premature rupture of membranes (p-PROM), among a total of 355 416 singleton births in Norway during 1999-2005 with gestational age 17-44 weeks. Logistic regression was used to assess whether placental abruption was associated with PROM in preterm and term births. Placental abruption. The occurrence of placental abruption in p-PROM was higher than in the total study population, 11.0 per 1,000 (34 of 3 077) vs. 4.2 per 1 000 (1 495 of 355 416; adjusted odds ratio 2.6, 95% confidence interval 1.8-3.7). Restricting the analyses to preterm births, the occurrence of placental abruption was less in p-PROM (11.0 per 1,000) than in births without p-PROM (36.1 per 1 000; adjusted odds ratio 0.3, 95% confidence interval 0.2-0.4). In term births, no statistically significant association was observed. The findings suggest that in p-PROM the risk of placental abruption is not higher than in other preterm births; rather the opposite. However, comparing the risks in p-PROM and the total gestational age range, the present study confirmed results reported in previous studies of a higher risk of placental abruption in p-PROM than in the total birth population.

Complications of intrauterine intravascular transfusion for fetal anemia due to maternal red-cell alloimmunization

The purpose of this study was to establish the true procedure-related complication rate of intrauterine transfusion therapy. A cohort study of 254 fetuses treated with 740 intrauterine blood transfusions for red-cell alloimmunization in a single center in the years 1988 to 2001. Our database was searched for perinatal deaths, emergency deliveries, infections, and preterm rupture of membranes associated with intrauterine blood transfusion. Complications were categorized by two independent obstetricians as procedure-related (PR) or not procedure-related (NPR). Logistic regression analysis was used to identify risk factors for complications. Overall survival was 225/254 (89%). Fetal death occurred in 19 cases (7 PR) and neonatal death in 10 cases (5 PR). There were two cases of intrauterine infection with Escherichia coli (both PR) and two other cases of preterm premature rupture of membranes (1 PR) within a week of a procedure. Emergency delivery after a transfusion was performed in 18 pregnancies (15 PR). The total PR complication rate was 3.1%, resulting in an overall PR loss rate of 1.6% per procedure. Arterial puncture, transamniotic cord puncture, refraining from fetal paralysis, and advancing gestational age were associated with the occurrence of PR complications. Our study shows that intrauterine transfusion is a safe procedure, with a relatively low PR perinatal loss rate. Arterial puncture and transamniotic cord needling carry a high risk for serious complications, whereas fetal paralysis improves the safety of the procedure. This information on risks of intrauterine transfusion therapy may help to further improve the safety of intrauterine transfusions. Data on complication rates of intrauterine transfusions are essential in counseling patients.

Early diagnosis of gestational diabetes mellitus and prevention of diabetes-related complications

Objetive: To test the hypothesis that an early diagnosis of gestational diabetes mellitus (GDM) could avoid some diabetes-related complications. Study design: We compared the rates of pregnancy complications commonly related to diabetes between 189 (later screening group) and 235 (earlier screening group) women with GDM diagnosed before and after adding an universal glucose tolerance screening performed in the first antenatal visit to the traditional screening performed at 24–28 weeks of gestation. Results: Women in the later screening group were likely to have hydramnios (12.7 versus 2.1%, P<0.0001) and preterm deliveries (11.8 versus 5.5%; P=0.03). All cases of preterm premature rupture of membranes and fetal anomalies took place in the later screening group ( P=0.03, P=0.007, respectively). Statistical analysis was performed using the Student’s t-test, Mann–Whitney’s U-test, Fisher’s exact test and χ 2-test. Statistical significance was set at 95% level ( P<0.05). Conclusions: Early glucose tolerance screening could avoid some diabetes-related complications in women with gestational diabetes. However, further studies are needed to know if it should be done in all pregnant women or only in those with a high risk of developing diabetes.

Role of amnioinfusion in the management of premature rupture of the membranes at

Objective: We sought to evaluate whether serial amnioinfusions for persistent oligohydramnios can affect the perinatal and long-term outcomes in extreme cases of preterm premature rupture of membranes. Study Design: All singleton pregnancies with preterm premature rupture of membranes at <26 weeks’ gestation and lasting >4 days between January 1991 and June 1998 were included. Amniotic fluid volume was assessed as the maximum cord-free pocket with serial ultrasonographic examinations. Consenting women with persistent (>4 days) oligohydramnios (amniotic fluid ≤2 cm) received serial transabdominal amnioinfusions to maintain an amniotic fluid pocket >2 cm. The pregnancy, neonatal, and long-term neurologic outcomes of the cases that spontaneously maintained a median amniotic fluid pocket >2 cm (amnioinfusion-not-necessary group) were compared with those of women with oligohydramnios who underwent amnioinfusion but continued to have a median amniotic fluid pocket after preterm premature rupture of membranes ≤2 cm (persistent oligohydramnios group) and with those of women in whom oligohydramnios was alleviated by the procedure for at least 48 hours (successful amnioinfusion group). Statistical analysis included the Wilcoxon rank-sum test and the Fisher exact test, with a 2-tailed P < .05 considered significant. Results: Among the 49 women included in the study, 13 (26.5%) did not have oligohydramnios, the neonatal survival rate was 92%, and normal fetal lung development and neurologic outcome were achieved in all survivors. The remaining 36 women had oligohydramnios, and all underwent serial amnioinfusions, which successfully restored a median amniotic fluid pocket >2 cm for ≥48 hours in 11 (30%) patients. This successful amnioinfusion group was comparable with the persistent oligohydramnios group (n = 25) in gestational age at first amnioinfusion (median, 20.2 weeks; range, 16-25.6 weeks; vs median, 20.3 weeks; range, 16.5-24.2 weeks; P = .4), number of amnioinfusions (median, 3; range, 1-9; vs median, 3; range, 1-5; P = .4), and interval between amnioinfusions (median, 6 days; range, 4-14 days; vs median, 8 days; range, 6-43 days; P = .1). However, patients in the persistent oligohydramnios group had a significantly shorter interval to delivery, lower neonatal survival (20%), and higher rates of pulmonary hypoplasia (62%) and abnormal neurologic outcomes (60%) than the patients in the groups in which amnioinfusion was not necessary or was successful (all P ≤ .01). Conclusion: Pregnancies with preterm premature rupture of membranes–related oligohydramnios at <26 weeks’ gestation in which serial amnioinfusions successfully alleviate oligohydramnios have a perinatal outcome that is significantly better than the outcome in those with persistent oligohydramnios and is comparable with gestations with preterm premature rupture of membranes in which oligohydramnios never develops. (Am J Obstet Gynecol 2000;183:878-82.)

Advances in perinatal medical care — from our experience

In the last 30 years, maternal and perinatal mortality rates have markedly improved in Japan. These results are supported by the advanced technologies and newly developed treatments in obstetric and neonatal medicine, the evidence of which will be described through the authors' experiences. Ultrasound-guided treatments for fetuses and pediatric surgery for extremely tiny infants have been performed with cooperation among cardiac surgeons, anesthesiologists and perinatologists. The remarkable achievements in neonatal medicine are surfactant replacement therapy, application of high frequency oscillation (HFO) respirator, nitric oxide and extracorporeal membrane oxygenation (ECMO) systems and transcutaneous blood gas monitoring. The possibility to have a safe pregnancy and delivery arose for women with severe medical complications such as diabetes mellitus (DM), heart diseases, and hemo-dialysis, factors formerly regarded as contraindications to pregnancy. The accumulative data of these high-risk pregnancies treated in our center are introduced. It is noted that molecular mechanisms in fetal growth have been elucidated to some extent. The insulin-like growth factor I (IGF-I) and IGF-binding protein 1 (IGFBP1) system, and cytokines, are involved in the fetal growth. Newly developed treatments such as urinary trypsin inhibitor (Urinastatin) for prevention of preterm delivery and amnioinfusion to cases of preterm premature rupture of the membrane are summarized. Finally, the reference to advanced medicine and its side effects lead to broad discussions regarding the future development of perinatal medicine.

Effects of smoking, alcohol, and drugs of abuse on the outcome of “expectantly” managed cases of preterm premature rupture of membranes

We evaluated the outcome of pregnancies complicated by preterm premature rupture of membrane (PROM) in order to determine if tobacco, alcohol, or illicit drug usage were associated with alterations in pregnancy or neonatal outcome. A retrospective study of patients with a gestational age <36 weeks admitted between 1993 and 1996 with PROM were evaluated for their clinical characteristics and pregnancy outcome. Comparisons in outcome were made with respect to tobacco, alcohol, and/or illicit drug usage. Comparisons were made with gestational age (GA) of PROM, GA of delivery, latency period (LP), maternal age, initial cervical exam (by speculum), age, race, tocolytic use, chorioamnionitis, and birthweight. Student's t-test, Mann-Whitney test, and Chi-square analysis were used to evaluate for significant differences (significance set at P < 0.05). A total of 119 charts were evaluated. Differences were noted with respect to smokers vs. nonsmokers for latency period (6.0 days vs. 9.4 days, P < 0.03), age (29.1 years vs. 24.8, P < 0.001), and gravidity (4.2 vs. 2.8, P < 0.005). Differences were noted for use of alcohol and age (29.9 vs. 25.2, P < 0.006). Differences were also noted for the use of illicit drugs and the following variables: age (30.0 vs. 24.9, P < 0.001), gravidity (4.7 vs. 2.5, P < 0.006), latency (6.2 vs. 9.0, P < 0.009), and parity (2.6 vs. 1.2, P < 0.01). A difference was noted with respect to cocaine and latency period (5.8 vs. 9.0, P < 0.01), age (31.2 vs. 24.8, P < 0.001), gravidity (4.8 vs. 2.9, P < 0.01), and parity (2.6 vs. 1.2, P < 0.03), and the use of tocolytics (22% vs. 55.4%, P < 0.02). These relationships held after multivariate analysis was performed. There were no associations among use of tobacco, alcohol, drugs of abuse, or cocaine and respiratory distress syndrome, intraventricular hemorrhage, or necrotizing enterocolitis. The use of tobacco during pregnancy appears to shorten the latency period in pregnancies complicated by PROM. Cocaine abuse also appears to shorten the latency period. These shortened latency periods could potentially contribute to increased neonatal morbidity. Larger studies evaluating this are needed. J. Matern.–Fetal Med. 7:157–161, 1998. © 1998 Wiley-Liss, Inc.

Effects of smoking, alcohol, and drugs of abuse on the outcome of "expectantly" managed cases of preterm premature rupture of membranes.

We evaluated the outcome of pregnancies complicated by preterm premature rupture of membrane (PROM) in order to determine if tobacco, alcohol, or illicit drug usage were associated with alterations in pregnancy or neonatal outcome. Comparisons in outcome were made with respect to tobacco, alcohol, and/or illicit drug usage. Comparisons were made with gestational age (GA) of PROM, GA of delivery, latency period (LP), maternal age, initial cervical exam (by speculum), age, race, tocolytic use, chorioamnionitis, and birthweight. Student's t-test, Mann-Whitney test, and Chi-square analysis were used to evaluate for significant differences (significance set at P < 0.05). A total of 119 charts were evaluated. Differences were noted with respect to smokers vs. nonsmokers for latency period (6.0 days vs. 9.4 days, P < 0.03), age (29.1 years vs. 24.8, P < 0.001), and gravidity (4.2 vs. 2.8, P < 0.005). Differences were noted for use of alcohol and age (29.9 vs. 25.2, P < 0.006). Differences were also noted for the use of illicit drugs and the following variables: age (30.0 vs. 24.9, P < 0.001), gravidity (4.7 vs. 2.5, P < 0.006), latency (6.2 vs. 9.0, P < 0.009), and parity (2.6 vs. 1.2, P < 0.01). A difference was noted with respect to cocaine and latency period (5.8 vs. 9.0, P < 0.01), age (31.2 vs. 24.8, P < 0.001), gravidity (4.8 vs. 2.9, P < 0.01), and parity (2.6 vs. 1.2, P < 0.03), and the use of tocolytics (22% vs. 55.4%, P < 0.02). These relationships held after multivariate analysis was performed. There were no associations among use of tobacco, alcohol, drugs of abuse, or cocaine and respiratory distress syndrome, intraventricular hemorrhage, or necrotizing enterocolitis. The use of tobacco during pregnancy appears to shorten the latency period in pregnancies complicated by PROM. Cocaine abuse also appears to shorten the latency period. These shortened latency periods could potentially contribute to increased neonatal morbidity. Larger studies evaluating this are needed.

Studies on the clinical implications of anaerobes, especially Prevotella bivia, in obstetrics and gynecology

Prevotella bivia is one of the anaerobic bacteria found in the resident flora of the female genital tract. The detection rate ofP. bivia has been poor, however, mainly due to problems such as the poor survival of this microbe in the presence of oxygen. To identifyP. bivia, it is necessary to start the culture, within 1 hour after sampling. We were able to isolate 13 strains ofP. bivia (32.5%) from 40 cases of preterm premature rupture of membrane, 8 strains (40.0%) from 20 cases of puerperal uterine endometritis, 20 strains (40.0%) from 50 cases of pyometra, 6 strains (40.0%) from 15 cases of severe pelvic inflammatory disease, and 6 strains (17.1%) from 35 cases of bacterial vaginosis. Most clinical isolates ofP. bivia were susceptible to the commonly used antimicrobial agents.P. bivia was detected concomitantly with aerobic bacteria, related to the alteration of vaginal microbial flora during the menstrual cycle.P. bivia increased in the follicular phase of the menstrual cycle, suggesting that the growth of this microbe might be partly regulated by sex steroids.

Effects of smoking, alcohol, and drugs of abuse on the outcome of “expectantly” managed cases of preterm premature rupture of membranes

Effects of smoking, alcohol, and drugs of abuse on the outcome of “expectantly” managed cases of preterm premature rupture of membranes

The effects of smoking, alcohol, and, drugs of abuse on the outcome of “expectantly” managed cases of preterm premature rupture of membranes

The effects of smoking, alcohol, and, drugs of abuse on the outcome of “expectantly” managed cases of preterm premature rupture of membranes

Maternal morbidity and perinatal outcome in preterm premature rupture of membranes before 37 weeks gestation.

OBJECTIVE: To assess the maternal morbidity and perinatal outcome in pre-term pre mature rupture of membranes between 24 to 37 weeks gestation. METHODS: This observational study was carried out in Gynaecology & Obstetrics Unit – I, at University Hospital Hyderabad, from October 2010 to October 2011. It included one hundred patients admitted through the outpatient department, as well as from casualty department of University Hospital Hyderabad. Detailed Clinical examination of the patient was done. Systemic review was also done to see any co-morbidity. All patients had laboratory investigations. Inclusion criteria were all patients gestational age between 24 to 37 weeks with preterm premature rupture of membrane (PPROM) confirmed by ultrasound and clinical examination regardless of their age. Exclusion criteria were patients with congenital anomalies, multiple pregnancy, pre-eclampsia & eclampsia, diabetes mellitus, polyhydramnios1 intrauterine growth restriction and placenta abruption. Data was collected using a proforma. Detailed workup including history, general physical examination, abdomen and pelvic examination and relevant specific investigations were noted. RESULTS: Out of 100 patients included in this study Primigravida were 17% and multigravida 83%. There was wide variation of age ranging from a minimum of 20to >40 years. The mean age was 30+ 3.1 years. Mostly patients belonged to the poor class in 72% cases followed by middle class in 21% and upper class 7%. Analysis shows that out of 100 mothers 26% had PROM of <24 hrs duration and 74% had >24 hrs of duration. Maternal outcome in 16 cases of Preterm Premature Rupture of Membrane findings revealed septicemia in 12% cases and Chorioamnionitis in 12% cases. Fetal outcome in 27 cases of preterm premature rupture of membrane revealed prematurity in 5% cases, fetal distress in 4% cases, cord compression in 5% cases, necrotizing enterocolitis in 2% cases, hypoxia in 9% cases and pulmonary hypoplasia in 2% cases. CONCLUSION: Low socioeconomic status is associated with increased neonatal morbidity due to fetal distress, cord compression, necrotizing enterocolitis, hypoxia and pulmonary hypoplasia at the time of delivery. An appropriate and accurate diagnosis of PROM is critical to optimize pregnancy outcome. It is suggested that the timely diagnosis and management of preterm PROM will allow obstetric care providers to optimize perinatal outcome and minimize neonatal morbidity.