Management of Premature Rupture of Membranes

Ashraf Olabi, Lucy Mousa
International Journal of Academic Scientific Research   unpublished
Context: review and compare the latent period, maternal, and neonatal morbidity and mortality in patient with premature rupture of membranes (PROM) managed expectantly either with prophylactic antibiotic or without. Objective: to determine if antibiotic treatment during expectant management of PROM will reduce maternal and infant morbidity and if it will prolong pregnancy. Design: analytical statistical prospective case-control study. Setting: Aleppo university hospital, department of
more » ... rtment of Obstetrics and Gynecology, Syria.. Patients: a total of 80 pregnant women > 28 weeks gestations with PROM were divided into 2 groups: Case group: patients with PROM managed expectantly with prophylactic antibiotics. Control group: patients with PROM managed expectantly without prophylactic antibiotics. Intervention : Intravenous ampicillin (2-g dose every 6 hours) for 48 hours followed by oral amoxicillin 500 mg dose every 8 hours orally for five days , plus one dose of azithromycine 1g at admition. Main outcome measures: Maternal outcome: maternal infectious morbidity such as chorioamnionitis, postpartum metritis and surgical wound infections. Neonatal outcome : birth weight, Apgar scores, ventilation assistance, rates of respiratory distress syndrome (RDS), intraventricular hemorrhage (IVH), necrotizing enterocolitis (NEC) ,neonatal infectious morbidity including (sepsis , pneumonia ,meningitis), and neonatal mortality.Median latent period. Results: Median latent period in the study group was significantly longer than in the control group P=0.044. Maternal infectious morbidity was comparable between groups P=0.14. Neonatal infectious morbidity was significantly lesser in study group P=0.02. Conclusion: we recommend that women with PROM with expectant management should receive prophylactic antibiotics to reduce infant and maternal morbidity and prolong latent period.