Fetomaternal Outcome in Expectant versus Active Management in Preterm Prelabor Rupture of Membranes Close to Term Pregnancy
European Journal of Molecular & Clinical Medicine,
2023, Volume 10, Issue 4, Pages 404-410
AbstractPPROM is defined as preterm prelabor rupture of membranes which complicates the pregnancy and is associated with around 40% of all preterm births. It is associated with other maternal and neonatal complications like ascending infections leading to chorioamnionitis and other complications. Principal of management of a case of PPROM is still not clear that weather an active intervention should be done or it should be managed conservatively.
Materials and Methods: This retrospective study was done in Obstetrics and Gynecology department at TMMC and RC, Moradabad. Data of last five years, from (2018-2022) was collected and analysed.
Results: A total of 647 patients were admitted in last 5 years with PPROM out of which 375 patients were excluded as per our exclusion criteria, from remaining 272 patients 143 were managed conservatively and 129 were in active management group. There were more cases of clinical chorioamnionitis and neonatal infection in expectant group while the cases of respiratory distress syndrome and oxygen requirement at 24 hours were more in active management group. There were statistically significant difference in the duration of admission to delivery interval and need for neonatal antibiotic treatment in both groups and was more in expectant management group.
Conclusion: Active management of PPROM at 34 weeks had higher cases of neonatal morbidity while expectant management group had higher rate of chorioamnionitis, so in our opinion the active management should be delayed till 35 weeks of gestation
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