Term Prelabour Rupture of Membranes and its Clinical Implications on Mother and Fetus

The study conducted was undertaken to assess labour outcomes in the patients admitted during term gestation, preliminary managed for prelabour rupture of membrane and associated maternal and fetal outcomes during labour and post-delivery.

Cases of spontaneous rupture of membranes with a singleton pregnancy with gestational age >37 weeks with confirmed PROM by a speculum examination were selected. A detailed history was taken and gestational age was confirmed with LMP and initial sonography of the first three months, general, systemic and obstetric examinations were done. Non stress test and blood investigations were done to rule out sepsis or early signs of chorioamnionitis. All patients received prophylactic antibiotics. After taking written informed consent, induction of labour was done with oral misoprostol. Maternal vitals were recorded every four hours, and fetal heart rate was monitored for variability. The time from induction to delivery was recorded, as well as the maternal and fetal outcomes after PROM. PROM was more common in Primigravida. Majority of women got admitted within 12 hours of PROM (87.83%). Recurrent episodes of urinary tract infection were found to be a significant cause of PROM (33.78%). The vaginal normal delivery rate was 55.40%. Post delivery complications included post partum sepsis in 12.16%. No maternal mortality was noted. Neonatal sepsis was seen in 6 babies (8.10%).

PROM is associated with numerous maternal and fetal complications, which can be avoided by educating women about the importance of regular antenatal checkups and early detection of urinary and genital tract infections. The treatment can be initiated appropriately for timely management to reduce maternal and fetal morbidities and mortalities.