Maternal and Neonatal Outcomes of Preterm Premature Rupture of Membranes (PPROM) with Amniotic Fluid Index More Or Less than 5 in a Tertiary Care Setting In Pakistan

Abstract

Objective: To explore the morbidity and mortality associated with preterm pre-labour rupture of membranes in the presence of amniotic fluid index (AFI) greater than or less than 5 in a tertiary care setting in Rawalpindi, Pakistan.

Study Design: Cross-sectional study.

Place and Duration of Study: Department of Gynaecology & Obstetrics, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Mar 2019 to Aug 2020.

Methodology: Data was collected from the patients presenting to the Department of Gynecology and Obstetrics at Pak emirates Military Hospital in Rawalpindi, Pakistan. Maternal and child outcomes were compared with an amniotic fluid index of less than or more than five among the patients with preterm premature rupture of membranes.

Results: 1562 deliveries took place in our department, among them 73 (4.67%) cases were diagnosed as PPROM. Caesarean deliveries and the development of chorio-amnionitis were observed statistically significantly more with an amniotic fluid index <5 (p-value <0.001). Neonatal complications such as sepsis, respiratory distress syndrome, hypoglycemia, jaundice and hypothermia were also significantly observed in the group with amniotic fluid index <5 (p-value <0.05). Neonatal mortality was also significantly higher in the group with an amniotic fluid index <5 (p-value: 0.004).

Conclusion: Preterm premature rupture of membranes was a relatively common finding among the patients managed at our labour unit. Such patients with an amniotic fluid index of less than five are at a high risk of maternal and fetal adverse outcomes.