Saadia Yasir, Bushra Kant, Tahira Jabbar.
Preterm pre labour rupture of membranes; effect of conservative management on feto maternal outcome.
Professional Med J Jan ;20(5):765-71.
Study Objective: The objective of this study is to describe the maternal and perinatal outcome of conservative management in PPROM. Design: Descriptive prospective study. Period: One year from August 2006 to August 2007. Setting: Maternal and child health (MCH) Centre PIMS Islamabad. Material and Methods: 50 patients between 28-36 weeks of gestation presenting with PPROM. Results: The mean age was 27+5.1 years, 14(28%) were having gestational age between 28to 32 weeks and 36 (72%) were between 33 to 36 weeks of gestation. 34 (68.0%) of the mothers had no history of abortions while 10 (20.0%) had 1-2 abortions and 6 (12.0%) had 3 or more abortions. Sixteen (32.0%) women had previous PRROM while 10 (20.0%) had previous history of preterm labor. Inverse correlation was observed between latency period and gestational age. Among 14(28%) women with gestational ages between 28 to 32 weeks 10 delivered within 48 hours and 4 after 48 hours. Among 36(72%) women with gestational ages between 33-36 weeks 31(62%) delivered in less than 48 hours and 5 (10 %) women delivered after 48 hours.14(28%) of the 50 babies were admitted in NICU with septicemia, 7(14.0%) with RDS, hypoglycemia in 2(4.0%) and necrotizing enterocolitis in 3(6.0%). 3 neonates died from septicemia and 2 from RDS. On first follow-up 34.0% mothers had infections and 8.0% had post-partum hemorrhage. Conclusions: Expectant management till 36 weeks is a suitable option as gestational age at delivery and birth weight both affect neonatal survival and offer time to administer corticosteroids to allow foetal lung maturity. Foetal deaths occurred due to septicaemia and RDS with direction co-relationship with low birth weight.
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