A Study to Evaluate Outcome in Neonates Born to Mothers with Premature Rupture of Membrane

Dr. Aishwarya, Dr. Yogesh Kumar Goel, Dr. Bhawna Kohli

Abstract: Introduction: Premature rupture of membranes (PROM) is a common and critical obstetric issue, contributing to 10% of perinatal deaths globally. It is a significant risk factor for early - onset neonatal sepsis and preterm births. Neonates born to mothers with PROM or preterm PROM (PPROM) are at an increased risk of complications such as fetal distress, prematurity, and umbilical cord compression. Other potential issues include skeletal deformities, impaired pulmonary development, pulmonary hypertension, chronic lung disease, and pulmonary hypoplasia. These infants are also at risk for birth asphyxia, necrotizing enterocolitis (NEC), intraventricular hemorrhage, and neonatal sepsis. Objectives: The objective of this study was to assess the outcomes in neonates born to mothers with PROM of greater than 18 hours' duration. The study also aimed to evaluate the role of the latency period between PROM and delivery on neonatal outcomes, and to determine the case fatality rate among neonates born to mothers with PROM for more than 18 hours. Methods: This prospective observational study was conducted at our hospital over a period of 24 months. A total of 80 neonates born to mothers with PROM lasting more than 18 hours were included in the study. Clinical features such as neonatal jaundice, lethargy, feeding difficulties, temperature instability, and respiratory distress were commonly observed. Laboratory investigations, including total count, CRP, cranial ultrasound, chest X - ray, and blood culture, were used to assist in diagnosis. Results: Perinatal morbidity was observed in 50% of the cases. Neonatal jaundice was the most common morbidity, affecting 37.93% of cases, followed by respiratory distress/TTN (27.58%), thrombocytopenia (18.96%), CRP - positive sepsis (18.96%), birth asphyxia (10.34%), apnea (10.34%), RDS (8.62%), and culture - positive sepsis (8.62%). The perinatal mortality rate was 1.72% (1 out of 80 neonates). As the gestational age increased, the latency period tended to decrease, and the incidence of perinatal morbidities also decreased. Conclusion: Pregnancies complicated by PROM are at a significantly higher risk of perinatal morbidities and mortality. The duration of the latency period and the period of gestation play a crucial role in influencing these outcomes, with shorter latency periods and earlier gestations correlating with higher morbidity and mortality rates.

Keywords: premature rupture of membranes, neonatal morbidity, latency period, neonatal sepsis, perinatal outcomes