Outcome of Active versus Expectant Management in Preterm Premature Rupture of Membranes between 34 weeks to 36 weeks Six days: A Retrospective Study
Introduction: An important cause of neonatal morbidity and mortality is the prelabour Preterm Rupture of the Membranes (PPROM) which refers to, the rupture of the membranes before 37 weeks. There are two modes of managing PPROM, active management (immediate delivery) and expectant management (t...
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2022-10-01
|
| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/17110/57083_CE(AD)_F[SK]_PF1(JY_OM)_PN(SS).pdf |
| Summary: | Introduction: An important cause of neonatal morbidity and
mortality is the prelabour Preterm Rupture of the Membranes
(PPROM) which refers to, the rupture of the membranes before
37 weeks. There are two modes of managing PPROM, active
management (immediate delivery) and expectant management
(therapy directed toward extending the pregnancy to improve
neonatal outcome).
Aim: To compare neonatal outcomes following active and
expectant (conservative) management in PPROM cases from
34 weeks to 36 weeks six days.
Materials and Methods: This retrospective study was
conducted in the Department of Obstetrics and Gynaecology at
Government Medical College (tertiary care teaching hospital),
Thiruvananthapuram Kerala, India, from February 2021 to
July 2021. The data collection period was from January 2013
to December 2014. PPROM cases between 34 weeks and
36 weeks and six days were retrospectively studied. A total
of 62 patients among the Active Management (AM) group and
62 patients among the Expected Management (EM) group
were selected. The neonatal outcomes (respiratory distress
syndrome, hypoglycaemia, neonatal sepsis) and maternal
outcomes (caesarean section, chorioamnionitis) were compared.
The latency period in conservative management and in active
management was also compared. The data was analysed using
the Chi-square test.
Results: In the AM group, 13 (21%) babies had respiratory
distress syndrome, whereas, in the EM group it was 4 (6.5%)
(p-value=0.019). In the AM group, 13 (21%) babies had
hypoglycaemia, whereas, in the EM group, it was 5 (8.1%)
(p-value=0.041). In the AM group, 3 (4.8%) women had signs
and symptoms of chorioamnionitis, whereas, in the EM group, it
was 7 (11.3%) (p-value=0.187). In the AM group, 16 (25.8%) of
women had Caesarean section, whereas, in EM it was 9 (14.5%)
(p-value=0.117). In AM group, 1 (1.6%) has neonatal sepsis
and in EM it was 3 (4.8%) p-value=0.309. The latency period
in conservative management was 119.5±31 hours and in active
management, it was 51.5±13.2 hours.
Conclusion: The present study indicated that expectant
management of PROM between 34 weeks to 36 weeks and six
days leads to a statistically significant reduction of neonatal
respiratory distress syndrome and hypoglycaemia. |
|---|---|
| ISSN: | 2249-782X 0973-709X |