STUDY ON PREGNANCY OUTCOME IN PRETERM PREMATURE RUPTURE OF MEMBRANES WITH OLIGOHYDRAMNIOS
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 62
Abstract
BACKGROUND Pregnancy outcome in preterm premature rupture of membranes is affected by AFI. PPROM with oligohydramnios (AFI<5) affects maternal outcome in terms of latency period, complications like chorioamnionitis, mode of delivery, and maternal sepsis. It also affects neonatal outcome in terms of neonatal weight, APGAR score, NICU admission, neonatal sepsis and neonatal death. MATERIALS AND METHODS This prospective observational study was carried in Department of Obstetrics and Gynaecology, Patna Medical College and Hospital, Patna, which included pregnant mothers attended and admitted through antenatal clinic OPD and Emergency of gestational age less than 37 weeks with complaining PPROM over a period of 2 years. Total 150 singleton pregnancies with PPROM without any other indications of immediate delivery or other cause of oligohydramnios were studied. RESULTS Incidence of PPROM was 2.6%. Out of 150 Cases studied, 82 (54.6%) were in group I (AFI<5) and 68 (45.33%) were in group –II (AFI≥5). The results showed that parity, gestational age at rupture, gestational age at the time of delivery, and mean of neonatal weight were almost equal. However, latency was significantly shorter in group I (AFI<5) than in group II (AFI≥5) with p value of 0.001. Total no. of maternal sepsis cases was higher in group- I (3.6%) as compared to group II (1.4%). Out of 150 cases, 112 (74.66%) delivered vaginally and 38 (25.33%) delivered by LSCS. Foetal distress was significantly higher in group I (AFI<5) compared to group II. (P value-0.021). Whereas failed induction was the most common cause of LSCS in group II (P value – 0.004). No. of neonates with first minute APGAR score ≤7 was significantly higher in group I (AFI<5) compared to group II (p=0.001). There was significant difference in NICU admission rate (p value 0.001), early neonatal sepsis (p value 0.021) and early neonatal death (p value 0.031). CONCLUSION Preterm premature rupture of the foetal membranes with oligohydramnios remains a major cause of preterm delivery, high rate of LSCS, shorter latency and high neonatal morbidity and mortality
Authors and Affiliations
Supriya Kumari, Chitra Sinha, Chander Kiran, Arpana Kumari
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