A study on active versus expectant management and perinatal outcome of preterm premature rupture of membranes between 32-37 weeks of pregnancy

Vijayalakshmi, N (2014) A study on active versus expectant management and perinatal outcome of preterm premature rupture of membranes between 32-37 weeks of pregnancy. Masters thesis, Madras Medical College, Chennai.

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Abstract

INTRODUCTION: PPROM is defined as a rupture of the amniotic membranes before 37 weeks of gestation and before the onset of labour. PPROM is one of the high risk factor leading to approximately one third of preterm births and it complicates about 3% of pregnancies. It is associated with many neonatal and maternal complications including neonatal sepsis, hyaline membrane disease (HMD), placental abruption, and eventually fetal death. OBJECTIVES: 1)To study active versus expectant management in preterm premature rupture of membranes (PPROM) between 32-37 weeks of pregnancy.2)To estimate the prevalence and identify the risk factors of preterm premature rupture of membranes. 3) To study the perinatal outcome of preterm premature rupture of membranes. MATERIALS AND METHODS: This study was conducted in Govt. Kasturba Hospital, Triplicane, Madras Medical College, Chennai from December2012 to November 2013 with ethical committee approval. 108 patients with gestational age of 32-36 completed weeks (37 weeks) with confirmed ROM, Singleton pregnancy, primi and multigravida in the age group between 15-35 years were randomly allocated to active and expectant management groups. The admission, management procedures and events during delivery and puerperium and neonatal outcome were studied. RESULTS: The incidence of PPROM was 3.56%. It was high in 34-36 weeks of gestation. The mean MRO duration during admission was 14.91 hours, admission to delivery interval 15.81 hours. The incidence of LSCS in active management is 32.12 % whereas in expectant group is 16.9%.The duration of mother hospitalization and post-operative complications like fever, abruption placenta were not statistically associated with active and expectant management (p>0.05). A statistically significant (p=0.007) differentiation in neonatal hospitalization, RDS were noted in both groups. Admission delivery interval was significant in both 32-34 as well as 34-36 weeks preterm PPROM. CONCLUSION: The incidence of PPROM is comparatively low because of improved living conditions and regular obstetric care. Active management by means of induction of labour between 34-36 completed weeks and expectant management between 32-34 weeks is safer for mother and fetus in pregnancies complicated by PPROM.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Preterm premature rupture of membranes ; RDS ; Active management ; Expectant management.
Subjects: MEDICAL > Obstetrics and Gynaecology
Depositing User: Subramani R
Date Deposited: 25 Nov 2017 06:09
Last Modified: 24 Jun 2018 11:38
URI: http://repository-tnmgrmu.ac.in/id/eprint/4038

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