Abstract:

To analyze maternal and fetal outcomes of PPROM (preterm premature rupture of membranes), which is an important and frequent cause of premature birth, neonatal morbidity and mortality. METHODS: In this study, 94 PPROM patients who had consulted to the Gynecology and Obstetrics Clinics of Dicle University Faculty of Medicine between January 2011 and December 2012 were analyzed retrospectively. Ages, number of gravidas, parities, miscarriages, living children, obstetrical histories, gestational weeks at childbirth, clinical findings, laboratory values, types of deliveries, indications of C sections, fetal birth weights and fetal lengths and 1.-5. minute- APGAR scores were assessed. Results: The incidence of PPROM was 3.8% in our hospital. Mean gestational week at birth and follow-up period of our patients were 31.5±3.1 weeks and 6.1±2.2 days, respectively. Mean C-reactive protein value and White Blood Cell count of our patients on admission were 3.2±4.4 mg/dl and 13626.9±3369.7/mm3, respectively. Steroid therapy was given to 66 (70.2%) patients with gestational age of < 34 weeks so as to July fetal pulmonary maturity. Febrile episodes (> 37.5 oC) developed in 14 (14.9%) patients. Growth of E.coli strains was observed in vaginal and cervical cultures of 13 (13.8%) patients. Patients with PPROM were delivered via normal vaginal route (n=51; 54.3%) or cesarean section (n=43; 45.7%). Newborns were brought into observation room (n=48; 51.1%) or neonatal intensive care unit (NICU) (n=46; 48.9%). Fourteen (14. 9%) newborns monitored in the NICU died within 24 hours after birth. Five (5.3%) newborns were lost due to sepsis. Mean gestational age of the deceased newborns at delivery was 26.7±1.6 weeks. One- and five minute -APGAR scores increased in parallel with longer gestational weeks of the newborns at birth (r=0.660, p=0.000 and r=0.695, p=0.000, respectively) DISCUSSION AND CONCLUSION: PPROM is still considered as a prevalent obstetrical complication which leads maternal and/or fetal morbidity and mortality. The patients who seek medical care should be carefully assessed, definitive diagnosis should be absolutely established and patient specific treatment should be instituted in consideration of all complicating factors of pregnancy predominantly gestational week and infectious manifestations. These cases should be monitored and treated in advanced centers which can provide healthcare services in their adult and neonatal intensive care units.

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