Study of Feto-Maternal Outcome in Premature Rupture of Membranes at Term Pregnancy in a Tertiary Care Institute

Abstract

Background. The Term “Preterm Rupture of Membranes” (PROM) complicates approximately 8-10% of all pregnancies and is associated with increased maternal as well as neonatal morbidity. This study aimed to assess Feto-maternal outcomes following PROM in term pregnancy and the role of the duration of membrane rupture in the development of complications.

Methods. Hospital-based observational study of 120 pregnant women with laboratory-proven term PROM (≥37 weeks of gestation). The participants were stratified by rupture time (<12 hours or ≥12 hours) to compare associated outcomes. Maternal outcomes like chorioamnionitis, sepsis in the puerperium, and mode of delivery were noted. Neonatal outcomes such as Apgar scores, birth weight, neonatal sepsis, and NICU admission were also recorded. Chi-square tests and logistic regression were performed to identify significant associations and independent predictors of complications. All the Data were analyzed using SPSS version 26.

Results. Long rupture (≥12 hours) was strongly associated with increased maternal complications (60% vs 30%, p=0.01) and cesarean section (70% vs 40%, p=0.03). The most frequent maternal complication was chorioamnionitis (12.5%), followed by puerperal sepsis (8.3%). Neonatal sepsis rates were three-fold higher with prolonged rupture (30% vs 10%). Low birth weight significantly increased NICU admissions (66.7% vs 20%, p=0.005). Irregular antenatal care was associated with five-fold higher maternal complications (57.1% vs 11.8%, p=0.001). Multivariable analysis identified prolonged rupture (AOR 3.25, p=0.004), low birth weight (AOR 2.90, p=0.018), abnormal Apgar score (AOR 2.85, p=0.017), and irregular antenatal care (AOR 2.75, p=0.030) as independent predictors of sepsis among neonates.

Conclusion. Prolonged membrane rupture significantly increases risks of maternal morbidity, cesarean delivery, and neonatal sepsis. The evidence supports active management of the term PROM, particularly when rupture is more than 12 hours, to reduce infectious morbidity as well as improve maternal and neonatal outcomes.