When membranes rupture before the onset of labor, it is known as premature rupture of membranes (PROM). When PROM occurs before 37 completed weeks of gestation it is termed as preterm premature rupture of membranes (p PROM). In such cases, fetomaternal complications are substantial. Preterm pre-labor rupture of membranes (pPROM) causes one-third of preterm births and contributes to significant perinatal morbidity and mortality.
Methods: A cross sectional case control study was conducted in patients with PROM who met the following inclusion criteria: (i) singleton gestation; (ii) gestational age between 15 and 36.9 weeks. All samples were collected in a single institution between December 2017 and December 2018. Diagnosis of PROM was based on history taking, clinical findings and laboratory reports. In all cases, liquor amnii was collected with Sim’s speculum, intracervical and high vaginal swabs and in cases of caesarean section, by amniocentesis just before making uterine incision. The samples were subjected to gram staining and aerobic culture and sensitivity test for detection of microorganisms. Condition of the baby at birth was observed and recorded as APGAR score at 1 and 5 minutes after birth. Birth weight and weight at discharge were recorded. Any interventions and complications were recorded till discharge. Maternal conditions and complications (if any) after delivery, till the time of discharge were observed and recorded.
Result: Incidence of PPH was 9.3% (n=14) in PROM cases as compared to 3% in control group. Chrioamnionitis Incidence was higher in PROM group 40% (n=60) as compared to control group15% (n=23). Most common organism isolated was Escherisia coli 10% (n=15) followed by Staph aureus 6%(n=10). Preterm babies constituted 21% of total deliveries of PROM as compared to 6% of control group. Among PROM cases chrioamnionitis was found in 62% of preterm cases as comapared to 20% in term babies born in PROM group.neonatal mortality was also significantly high in neonates in PROM group 13% (n=20) as compared to control group 5% (n=8).