A Study On Active And Expectant Management And Its Outcome On Preterm Premature Rupture Of Membranes Between 32 And 37 Weeks Of Pregnancy In Southern India
Journal Title: National Journal of Research in Community Medicine - Year 2015, Vol 4, Issue 2
Abstract
Date of Submission: 08.05.2015 Date of Acceptance: 30.06.2015 Abstract PPROM is preterm premature rupture of a membrane that occurred before the onset of labour and before term. A prospective comparative study was conducted to find out the incidence of PPROM and examine the various modes of treatment options. This study was conducted in Govt. Kasturba Hospital, Triplicane, Madras Medical College, Chennai in the period of December 2012 to November 2013. Pregnant women with gestational week of 32-36 completed weeks with confirmed ROM, Singleton pregnancy, Primi and multigravida in the age group between 18-35 years were included. Sample size was calculated to 108 by using 7.72% prevalence of PPROM and 5% precision. The incidence of PPROM was 3.62%. It was high in 34-36 weeks of gestation. 55 clients were put up in active management and 53 in expectant management. The mean MRO duration during admission was 14.91 hours, admission to delivery interval 15.81 hours and MRO to delivery interval 30.72 hours. Oxytocin induction was high (49) in active management than in expectant management (6). Only three patients were given PGE-2 gel for induction in active management. The highest number of mothers (94.44%) got admitted in > 24 hrs of MRO in active management but it was highest in <6 hrs in expectant management while comparing between the group. Among delivered within <6hrs after hospital admission, 88.24% in active and 11.76% in expectant management group. These differences were statistically significant. E-coli were identified in 9.25% of high vaginal swabs. The duration of mother hospitilization and postoperative complications like fever, abruption placenta were not statistically associated with active and expectant management (p>0.05). The duration of neonate hospitalisation was more than 5 days in 62.26% in expectant management and 37.74% in active management. The same was less than 5 days in 63.34% in active and 36.36% in expectant management. The difference was statistically significant (p=0.007). Apgar score of 1 min and 5 min between the treatment group was not statically significant. Expectant management is best management for MRO with mother’s gestational age of 32-33weeks 6 days and active line of management is for 34-36 weeks 6 days.
Authors and Affiliations
Vijayalakshmi N, Sampath kumari S, Prabakaran Jayaraman
Keywords
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