Maternal Demography and Neonatal Outcomes in Term Pre Labour Rupture of Membranes Versus Spontaneous Labour Preceding Ruptured Membranes in Lagos, Nigeria: A Comparative Study


Authors : Yusuf Abisowo Oshodi; MuyideenOladipo Oyedeko; TawaqualitAbimbolaOttun; Fatimat Motunrayo Akinlusi; Joy OnyinyechiChionuma

Volume/Issue : Volume 8 - 2023, Issue 3 - March

Google Scholar : https://bit.ly/3TmGbDi

Scribd : https://bit.ly/3KjDKi0

DOI : https://doi.org/10.5281/zenodo.7783889

Abstract : Term prelabour rupture of membranescomplicates about 5% to 10% of term pregnancies and imposes therapeutic challenges upon the managing obstetrician. While spontaneous labour followed by ruptured membranes is the accepted default pathway towards delivery at term, comparative studies on term PROM and spontaneous onset of labour preceding ruptured membranes are scarce globally. Objective: To compare maternal socio-demography and neonatal outcomes of term PROM versus spontaneous onset of labour before membrane rupturein our tertiary facility. Methods: A prospective comparative study of 300 subjects allocated intothe study group comprising 150 subjects with prelabour rupture of membranes and the other 150 subjects with spontaneous labour before membrane rupture as the control group. Data were obtained on maternal sociodemographic characteristics and neonatal outcomes in both groups.Epi-info statistical softwarewas deployed for data analysis. Results: The incidence of premature rupture of membranes was 9.23%. Term PROM was highest in the age group 20-29 years while subjects with low socioeconomic status accounted for 58.7% in the study group. The study group had higher caesarian delivery than the control (22.6% versus 8.0%; P < 0.001). One hundred and thirty-nine (139) babies of subjects in the study group had APGAR scores> 7 compared to 149 babies of subjects in the control group (P < 0.001). More neonates in the study group were admitted into the Neonatal Intensive Care Unit (NICU) compared to the control (6.7% versus 0.7%; P = 0.025). Seven neonates in the study group had Neonatal sepsis compared to none in the control group(P < 0.01). Similarly, three perinatal death were recorded in the study group compared to none in the control group (P = 0.06). Conclusion: Actively managed term PROM was significantly associated with unbooked maternal status, poorer Apgar scores, higher rate of caesarian delivery, and increased perinatal morbidity and mortality compared to spontaneous labour before membrane rupture.

Keywords : term prelabour ruptured membranes, spontaneous labour before membrane rupture, maternal demography, neonatal outcomes.

Term prelabour rupture of membranescomplicates about 5% to 10% of term pregnancies and imposes therapeutic challenges upon the managing obstetrician. While spontaneous labour followed by ruptured membranes is the accepted default pathway towards delivery at term, comparative studies on term PROM and spontaneous onset of labour preceding ruptured membranes are scarce globally. Objective: To compare maternal socio-demography and neonatal outcomes of term PROM versus spontaneous onset of labour before membrane rupturein our tertiary facility. Methods: A prospective comparative study of 300 subjects allocated intothe study group comprising 150 subjects with prelabour rupture of membranes and the other 150 subjects with spontaneous labour before membrane rupture as the control group. Data were obtained on maternal sociodemographic characteristics and neonatal outcomes in both groups.Epi-info statistical softwarewas deployed for data analysis. Results: The incidence of premature rupture of membranes was 9.23%. Term PROM was highest in the age group 20-29 years while subjects with low socioeconomic status accounted for 58.7% in the study group. The study group had higher caesarian delivery than the control (22.6% versus 8.0%; P < 0.001). One hundred and thirty-nine (139) babies of subjects in the study group had APGAR scores> 7 compared to 149 babies of subjects in the control group (P < 0.001). More neonates in the study group were admitted into the Neonatal Intensive Care Unit (NICU) compared to the control (6.7% versus 0.7%; P = 0.025). Seven neonates in the study group had Neonatal sepsis compared to none in the control group(P < 0.01). Similarly, three perinatal death were recorded in the study group compared to none in the control group (P = 0.06). Conclusion: Actively managed term PROM was significantly associated with unbooked maternal status, poorer Apgar scores, higher rate of caesarian delivery, and increased perinatal morbidity and mortality compared to spontaneous labour before membrane rupture.

Keywords : term prelabour ruptured membranes, spontaneous labour before membrane rupture, maternal demography, neonatal outcomes.

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