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Survey of Pregnancy Outcome in Preterm Premature Rupture of Membranes; [بررسی پیامدهاي بارداري در خانمهاي مبتلا به پارگی پیش از موعد کیسه آمنیون]



Zafarbakhsh A1 ; Fateminia E1 ; Babak A2 ; Khanjani S1 ; Shariat M3 ; Haghollahi F4
Authors
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Authors Affiliations
  1. 1. Department of Obstetrics and Gynecology, School of Isfahan, Isfahan University of Medical Sciences, Isfahan, Iran
  2. 2. Department of Social Medicine, School of Isfahan, Isfahan University of Medical Sciences, Isfahan, Iran
  3. 3. Maternal Fetal & Neonatal Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran

Source: Tehran University Medical Journal Published:2024

Abstract

Background: Preterm premature rupture of membranes (PPROM) significantly impacts perinatal mortality and maternal-fetal outcomes. The purpose of this study is to investigate the frequency of maternal risk factors, maternal and fetal outcomes and the role of care in the occurrence of outcomes. Methods: This retrospective cross-sectional study involved 317 pregnant women with premature rupture of membranes (PPROM) at Shahid Beheshti Hospital in Isfahan, between April 2020 and April 2022. Data were collected from medical records, including demographic information, risk factors, and maternal and neonatal outcomes. Patients were categorized into two groups: those receiving care (24-34 weeks of gestation) and those undergoing pregnancy termination (less than 24 weeks or more than 34 weeks). The chi-square test was used for qualitative variables, while the T-student test was applied for quantitative variables. Results: In this study, the average age of patients was 29.42±6.56 years. The most common risk factors for PPROM were 20.2% for abortion records, 20.2% for urinary infections, 18% for cervical insufficiency, and 13.6% for gestational diabetes. Comparing maternal outcomes between the two groups revealed that chorioamnionitis occurred more frequently in the care group (18% vs. 2%, P=0.0001), as did emergency cesarean sections (37% vs. 4.5%, P=0.0001) and NICU hospitalization (71% vs. 17%, P=0.001). In the next stage, a regression test identified the independent effects of variables on maternal and newborn outcomes without intervention or confounding factors. The analysis indicated that mothers in the care group experienced significantly more complications than those in the pregnancy termination group, and their babies also faced significantly more complications. Conclusion: The study results indicate that a history of abortion, urinary infections, cervical insufficiency, and gestational diabetes are significant risk factors for PPROM. Expectant management of PPROM is associated with more neonatal and maternal complications than pregnancy termination. Thus, timely identification of these risk factors allows healthcare providers to educate mothers and potentially prevent and manage them, significantly reducing the incidence of PPROM and its complications. Copyright © 2024 Zafarbakhsh et al.