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Abstract

PERINATAL OUTCOME OF THE INCIDENCES OF PROM AND PPROM – A RETROSPECTIVE STUDY

Dr. Vadiraj Havaldar*, Dr. Uma, Dr. Nadia Ahmed, Dr. Rajkumar Mandal, Dr. Sumit Mishra

ABSTRACT

Objective: To study perinatal morbidity and mortality of the premature rupture of the membranes (PROM) and preterm premature rupture of the membranes (PPROM), and any complications to the mother after delivery in PROM and PPROM cases treated with antibiotics and tocolytics in labour room and also in NICU. Materials and Methods: About 100 women with singleton pregnancy diagnosed as PROM and PPROM were grouped into two groups. The first group about 50 cases treated with orally Ampiclox, parentally Cephalosporin and Metronidazole for 5 to 7 days, after confirmation that it is PROM and PPROM. The second group, 50 cases treated with parentally Isoxsuprine followed by orally Isoxsuprine for 7 to 8 days, after confirmation of PROM and PPROM. In all cases in PPROM corticosteroids inj. Dexamethasone 12 hours apart, 2 doses were given to mother. The composite primary outcome included pregnancies complicated by at least one of the following: fetal or infant death, respiratory distress, severe intraventricular hemorrhage, stage 2 or 3 necrotizing enterocolitis, or sepsis within 72 hours of birth. These perinatal morbidities were also evaluated individually and pregnancy prolongation was assessed. Results: In first group RDS in PPROM cases 22% +/-3.4%. Second group RDS in PPROM is 3.2%+/-1.4%,so there is little significance between the two groups. In sealing of PROM and PPROM in first group and continuing the progress of labour up to 37 weeks is almost 97%+/-1.2%. In second group the sealing of PROM and PPROM without antibiotics is 5.8%+/-2.5%. In first group chorioamniotis with the symptoms of high fever and tenderness in lower abdomen is 2 %+/-1.8%. In second group it is 2.1%+/-1.7%. Discussion and Conclusion: Intrauterine infection has clearly shown that there is definitely contributing factor for PROM and PPROM. Significantly it contributes to the mortality and morbidity of the foetus and pregnant women. Tocolytic agents in controlling PROM and PPROM are insignificant. We conclude that intra uterine infection is major contributing factor in PROM and PPROM and also producing maternal and foetal complications.

Keywords: PROM and PPROM, Antibiotics, Perinatal morbidity and mortality, Maternal morbidity and mortality.


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