Fetomaternal Outcome in Expectant Management of Prom at Term

Abstract

Background: PROM is defined as rupture of membranes that occurs at term. It occurs in 8% of pregnancies. 50% of patients deliver within 5 hours of membrane rupture and 95% of patients deliver within 28 hours. Aim: To determine maternal and fetal outcome of expectant management for 24 hours in patients of pre-labour rupture of membranes at term Study Design: Descriptive case series. Study Setting: The study was carried out in the Department of Obstetrics and Gynaecology Unit-I, Services Hospital, Lahore Study duration: Study was conducted from 01-10-2009 to 31-03-2009. Methods: Total 490 cases were included in this study. Patients were followed for 24 hours to see spontaneous onset of labour, development of chorioamnionitis and augmentation with syntocinon done or not, baby was followed as for admission to NICU, development of sepsis( temperature > 101°F) and convulsion. Data was entered and analyzed in SPSS ver.: 17.0., frequency and percentages were calculated for maternal and fetal outcome. Results: Out of 490 patients, 75 (15.3%) were less than 20 year, 351 (71.7%) were between 21-30 while remaining 64 (13.0%) were between 31-40 years of age with mean age of 28.9±4.7 years. According to maternal outcome, spontaneous onset of labour had 282 patients (57.5%), clinical chorioamnionitis developed in 90 (18.3%) and augmentation was required in 300 patients (61.2%). Admission to NICU were 122 (24.9%) and neonatal sepsis developed in 37 (7.5%) neonates. Regarding gestational age, 397 (81.0%) patients had gestational age between 37-40 and 93 (19.0%) had 41-42 weeks of gestation Conclusion: Expectant management in patients with ruptured membranes at term is safe and reduces the frequency of operative vaginal deliveries.