Neonatal and Maternal Outcome after Conservative Management of Preterm Premature Rupture of Membranes (PPROM) between 24-28 Weeks Gestation | ||||
| The Egyptian Journal of Fertility of Sterility | ||||
| Article 6, Volume 25, Issue 1 - Serial Number 11106352, January 2021, Page 46-56 PDF (3.01 MB) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/egyfs.2021.143090 | ||||
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| Author | ||||
Yasser Mesbah 
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| Associate professor Department of Obstetrics and Gynaecology Mansoura University Hospital Mansoura Facult | ||||
| Abstract | ||||
| Background:The Incidence of preterm pre mature rupture of membranes ranges from 3.0-10.0% of all deliveries and leads to one third of preterm births. There are several risk factors for PPROM, such as intrauterine infection at early gestational age, sexually transmitted infections, vaginal bleeding, and smoking during pregnancy. Methods: An observational prospective study included 100 pregnant females with PPROM between the 24th and 28th week’s gestation that were admitted to Mansoura University Hospital (MUH) between April 2018 and December 2019. Pregnancies with known fetal malformations, multiple fetuses, stillbirths, placenta previa, pre-eclampsia & Eclampsia and diabetes mellitus were excluded from this study group. Women who deliver within 24 hours of PPROM were also excluded. Results: Out of 100 pregnant females were eligible for the study only 88 patients continued the study. Data from our study showed that the median gestational age at delivery after conservative management of patient diagnosed to have PPROM was 33 weeks. 85.2% of patients delivered by cesarean section. Recurrent urinary tract infection and Vulvo-vaginitis are the most common associated risk factors (28 %, 24 %) respectively.The percentage of live born neonates was (65.9%) while still birth occurred in (15.9%) and miscarriage occurred in (18.2%) of the females who completed the study. The main neonatal complications reported in the study was 55 out of 58 live birth cases were admitted to NICU (62.5%). Twenty-nine cases developed respiratory distress syndrome (32.9 %), 17 cases developed bronchopulmonary dysplasia (19.3%), 6 cases developed pulmonary hypoplasia (6.8%),47 casesdeveloped neonatal sepsis (53.4%) and 34 cases developed perinatal death after admission to NICU (38.6%). Fourteen neonates were discharged with different degrees of disability (15.9%). The overall survived neonates were 24 cases (27.3%). For maternal complications we noticed that 43 cases developed signs of chorioamnionitis (48.9%). Also cord prolapse was reported in 3 cases (3.4%). After delivery postpartum hemorrhage occurred in 14 cases (15.9%) and 10 cases (11.4%) were in need of blood transfusion. Signs of maternal sepsis developed only in 3 cases (3.4%). Conclusion: Data from our study showed that after conservative management of patients with PPROM the overall neonatal survival rate was 27.3 %. 3.4% of neonates were discharged without need of NICU, 7.95% of neonates were healthy after being discharged form NICU and 15.9 % of neonates were discharged with different degrees of disability. Most of material complication were not fatal and showed improvement after giving the appropriate care. | ||||
| Keywords | ||||
| Preterm labor; neonatal outcome; chorioamnionitis; prematurity; maternal sepsis | ||||
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