RISK FACTORS OF PREMATURE RUPTURE OF MEMBRANES IN AYUB TEACHING HOSPITAL: A CASE CONTROL STUDY
Background: Premature rupture of membranes (PROM) is one of the important causes of preterm delivery and is associated with increased incidence of neonatal and maternal morbidity and mortality worldwide. The aim of this study was to find out the risk factors associated with PROM in patients admitted to Obstetrics Ward of Ayub Teaching Hospital, Abbottabad. Methods: This case control study was conducted on pregnant females (>28 weeks gestation) from 1st November, 2018 to 30th May, 2019. The sample size was 195 patients (130 controls, 65 cases in 2:1 ratio) collected through convenient sampling. Data was analysed using SPSS-16. Odds ratio with confidence interval was used to estimate the strength of association of PROM with its risk factors, and p≤0.05 was considered significant. Results: The mean age of the patients was 25.48±3.65 years ranging between 19–38 years. Most of the patients belonged to the age group 26–35 years. Most women were illiterate, unemployed, and had poor socio-economic background. The most important risk factors of PROM were PROM in previous pregnancies (OR=3.978, CI=1.484–10.666, p=0.012), foul smelling vaginal discharge (OR=2.700, CI=1.197–6.089, p=0.014), polyhydramnios (OR=2.5, CI=1.178–5.404, p=0.015), and vaginal bleeding (OR=2.486, CI=1.117–5.534, p=0.023). Conclusion: PROM in previous pregnancies, foul smelling vaginal discharge, vaginal bleeding, and polyhydramnios were found to increase the risk of PROM significantly.
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Workineh Y, Birhanu S, Kerie S, Ayalew E, Yihune M. Determinants of premature rupture of membrane in Southern Ethiopia. BMC Res Notes 2018;11:927. https://doi.org/10.1186/s13104-018-4035-9
Khan S, Khan AA. Study on preterm pre mature rupture of membrane with special reference to maternal and its fetal outcome. Int J Reprod Contracept Obstet Gynecol 2016 ;5(8):2768-74
Gibbs R, Karlan B, Haney A, Nygaard I. Danforth’s obstetrics and gynecology. 10th ed. Philadelphia: Lippincott Williams & Wilkins;2008.
Caughey AB, Robinson JN, Norwitz ER. Contemporary Diagnosis and Management of Preterm Premature Rupture of Membranes. Rev Obstet Gynecol 2008;1(1):1–22.
Riyami NA, Al-Ruheili I, Al-Shezawi F, Al-Khabori M. Extreme preterm premature rupture of membranes:Risk factors and feto maternal outcomes. Oman Med J 2013;28(2):108-11.
Noor S, Nazar AF, Bashir R, Sultana R. Prevalance of PPROM and its outcome. J Ayub Med Col Abbottabad 2007;19(4):14-7.
Assefa NE, Berhe H, GirmaF,Berhe K, Berhe YZ, Gebreheat G, et al. Risk factors of premature rupture of membranes in public hospitals at Mekele city, Tigray, a case control study. BMC Pregnancy and Childbirth 2018;1(18):1-7.
Segni H, Diriba TD, Ali E. Incidence, Maternal and Perinatal Outcome of Premature Rupture of Fetal Membrane Cases in Jimma University Teaching Hospital, South West Ethiopia. EC Gynaecol 2017 ;4(5):163-72.
Alam MM, Saleem AF, Shaikh AS, Munir O,Qadir M. Neonatal sepsis following prolonged rupture of membranes in a tertiary care hospital in Karachi, Pakistan J Infect Dev Ctries 2014; 8(1):67-73.
Wang KC, Lee WL, Wang PH. Early and late preterm premature rupture of membranes. J Chin Med Assoc 2017 ;80(10):613-4.
Dars S, Malik S, Samreen I, Kazi RA. Maternal morbidity and perinatal outcome in preterm premature rupture of membranes before 37 weeks gestation. Pakistan J Med Sci 2014;30(3):626–9.
Medina TM, Hill DA. Preterm Premature Rupture of Membranes: Diagnosis and Management. Am Fam Physician 2006;73(4):659-64
Beckmann CRB, Ling FW, Barzansky BM, Herbert WNP, Laube DW, Smith RP. Obstetrics and Gynecology. 6 th ed. Philadelphia: Lippincott Williams & Wilkins; 2010.
Mishra S, Joshi M. Premature rupture of membrane- risk factors: a clinical study. IJCMR 2017; 4(1):146-8.
Neil PRL, Wallace EM. Is Amnisure useful in the management of women with prelabour rupture of the membranes? Aust N Z J Obstet Gynaecol 2010;50(6):534-8.
ACOG Committee on Practice bulletins. Practice bulletin No. 139. Obstet Gynecol 2013;122(4):918-30.
Nakubulwa S, Kaye DK, Bwanga F, Tumwesigye NM, Mirembe FM. Genital infections and risk of premature rupture of membranes in Mulago Hospital,Uganda: a case control study. BMC Res Notes 2015;8:573 DOI 10.1186/s13104-015-1545-6
Al-Hussain TK, Mohamed SN, El- dien HA, Ahmed AAE. Cervicovaginal Infection during Pregnancy and Its Relation to Preterm Pre-Labour Rupture Of Membranes. J Am Sci 2012;8(12):364-73.
Lee T, Carpenter M, Heber WW, Silver HM. Preterm premature rupture of membranes: risks of recurrent complications in the next pregnancy among a population-based sample of gravid women. Am J Obstet Gynecol 2003;188:209–13
Choudhary M , Rathore SB , Chowdhary J , Garg S. Pre and post conception risk factors in PROM. Int J Res Med Sci 2015;3(10):2594-8.
Gahwagi MM, Busarira MO, Atia M. Premature rupture of membranes characteristics, determinants, and outcomes of in Benghazi, Libya Open J Obstet Gynecol 2015; 5(09):494-504.
Endale T, Fentahun N, Gemada D, Hussen MA. Maternal and fetal outcomes in term premature rupture of membrane. World J Emerg Med 2016;7(2):147-52.
Hossain R, Harris T, Lohsoonthorn V, Williams MA. Risk of preterm delivery in relation to vaginal bleeding in early pregnancy. Eur J Obstet Gynecol Reprod Biol 2007 Dec;135(2):158-63.
Moore RM, Mansour JM, Redline RW, Moore JJ. The physiology of fetal membrane rupture: insight gained from the determination of physical properties. Placenta 2006;(27):1037–51.
Kayiga H, Lester F, Amuge PM, Byamugisha J, Autry AM. Impact of mode of delivery in pregnancy outcomes in women with premature rupture of membranes after 28 weeks of gestation in a low resource setting: A prospective cohort study. PLoS One;2018:13(1):e0190388
Pasquier JC, Rabilloud M, Picaud JC, Ecochard R, Claris O, Gaucherand P, et al. A prospective population based study of 598 cases of PPROM between 24 and 34 weeks gestation: description, management and mortality (Dominos cohort). Eur J Obstet Gynecol Reprod Biol 2005;121(2):164-70.
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