A prospective study on the neonatal compications associated with prolonged premature rupture of membranes at a tertiary care hospital: A comperative analysis

Background : Premature rupture of the membranes (PROM) is a common complication during pregnancy, which leads to adverse effects in both mothers and newborns. The management of premature rupture of the amniotic sac is still controversial among physicians, which is associated with a wide range of maternal and neonatal complications. Expectant management might increase the risk of infection in both mothers and neonates. Therefore, in this study we aimed to investigate neonatal outcomes following prolonged PROM(PPROM). Methods and material : This study is a prospective cross-sectional descriptive study. Based on the inclusion and exclusion criteria, 65 neonates with premature rupture of membranes longer than 18 hours and 65 neo-nates with premature rupture of membranes less than 18 hours were selected through random sam-pling.and included in the study through simple random sampling. After recording the demographic charac-teristics of the mothers and the neonates and the outcomes of the neonates, it was entered into the SPP version 22 software for statistical analysis. A significance level (p.value) less than 0.05 was considered significant Results : Out of 130 neonates, 57.7% were male and 42.3% were female. 62.3% of the neonates were born by cesarean section and the rest by vaginal delivery. In the studied population, 43% were pre-term neonates and the rest were term. The mean birth weight was 2825.35 ±572.34 grams and The mean Apgar score at fifth minute was 8.8 ± 1.19. The incidence rate of early neonatal infection (EOI) was 26.2% (34 cases) and the in-hospital death rate was 3.8% (5 cases). Based on our findings, the association between the duration PROM with early onset infection and resuscitation was statistically significant (p.value<0.05). The mean Apgar score at 5th minute was significantly higher in neonates with PROM longer than 18 hours than neonates with PROM less than 18 hours. Moreover, no significant association was observed between the duration of PROM and in-hospital mortality of neonates. Conclusion : Based on the findings of our study, it can be concluded that the increase in the duration of rupture of the amniotic sac until the onset of labor is associated with an increase in the rate of early onset neonatal infection, a low Apgar score in the fifth minute, and the need for higher levels of resuscitation. However, it is not associated with in-hospital mortality of newborns.