Dulumoni Borah, Kimaya Mali

A PROSPECTIVE STUDY OF ANALYSIS OF MATERNAL AND NEONATAL OUTCOME FOLLOWING PRETERM PRELABOUR RUPTURE OF MEMBRANE

  • General Medicine
  • General Earth and Planetary Sciences
  • General Environmental Science
  • General Medicine
  • Ocean Engineering
  • General Medicine
  • General Medicine
  • General Medicine
  • General Medicine
  • General Earth and Planetary Sciences
  • General Environmental Science
  • General Medicine
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Preterm rupture of membrane is defined as rupture of fetal membrane prior to 37 weeks of gestation in absence of uterine contraction complicates 3-4.5% of pregnancies globally. This condition is associated with high neonatal mortality and increased risk of long and short term neonatal morbidity. Altered membrane morphology including marked swelling and disruption of collagen network is triggered by bacterial products, pro- inflammatory cytokines. Activation of matrix mataloproteinase have been implicated in mechanism of preterm prelabour rupture of membrane. The propagation of bacteria is an important contributing factor not only in preterm prelabour rupture of membrane also adverse neonatal and maternal outcome after preterm prelabour rupture of membrane. Inflammatory mediator likely play a causative relation in both disruption of fetal membrane integrity and activation of uterine contractions. The management of preterm prelabour rupture of membrane requires balancing the potential neonatal benefit from prolongation of pregnancy with risk of intra- amniotic infection and its consequences for mother and infant. Antenatal administration of single course of corticosteroids before 34 weeks of gestation is associated with neonatal period of decreased respiratory distress syndrome (RBS). Intra ventricular haemorrage (IVH), necrotising enterocolitis ( NEC)and death and in possibly childhood with reduction of cerebral palsy and increased psychomotor development index and intact survival. Because of very favourable benefit risk balance antenatal administration of single course of corticosteroids is recommended for woman at risk of preterm delivery before 34 weeks.

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