The Incidence Rate and Perinatal Outcome of Delivered Women with Preterm Premature Rupture of Membrane, at a tertiary maternity hospital within a year
DOI:
https://doi.org/10.56056/408Keywords:
APGAR score, Fetal outcome, Preterm premature rupture of membraneAbstract
Background and objectives: Many maternal and perinatal complications can result from preterm premature rupture of membrane. This study aims to find the incidence and identify factors associated with, and factors associated with adverse perinatal outcomes among women experiencing preterm premature rupture of membrane.
Methods: A cross-sectional study was carried out at Maternity Teaching Hospital in Erbil to calculate preterm premature rupture of membrane incidence in 1 year from 2023 to 2024. Factors such as maternal age, parity, antenatal care, amniotic fluid index were studied as well as the neonate’s APGAR score, birth weight and outcome.
Results: For this study; 840 patients were included. The incidence of preterm premature rupture of membrane in 2023 at the maternity teaching hospital in Erbil was 2.18%. Younger age, lower BMI, nulliparity, and history of preterm premature rupture of membrane were associated with preterm premature rupture of membrane (p<0.05). Antenatal care was less common among preterm premature rupture of membrane (55.2% vs. 78.1%) (p<0.05). Preterm premature rupture of membrane was associated with lower APGAR scores in both 1st and 5th minutes of birth (p<0.05). Longer duration of preterm premature rupture of membrane before admission is associated with poor fetal outcome and lower APGAR scores (p<0.05).
Conclusion: preterm premature rupture of membrane impacts neonatal outcomes like birth weight and APGAR score. The time between preterm premature rupture of membrane and hospital admission significantly affects outcomes.
Downloads
References
1. Mohokar SA, Bava AK, Nandanwar YS. Analysis of maternal and perinatal outcome in cases of preterm premature rupture of membranes. Bombay Hospital J. 2015;57(3):285-290.
2. American College of Obstetricians and Gynecologists. Prelabor rupture of membranes: ACOG practice bulletin, number 217. Obstet Gynecol. 2020;135: e80–97. doi: 10.1097/AOG.0000000000003700/
3. Thomson AJ. Care of Women Presenting with suspected preterm prelabour rupture of membranes from 24+0 weeks of gestation. BJOG. 2019;126: e152–66. doi: 10.1111/1471-0528.15803/
4. Mamatha N, Bano A, Sabavath S. Clinical Study of the Incidence of Preterm Premature Rupture of Membranes and Maternal and Fetal Outcome. J Evol Med Dent Sci. 2020;9(43):3210-4.
5. Konar H. DC Dutta’s textbook of obstetrics. 8th ed. New Delhi: Jaypee Brothers Medical Publishers (P) Ltd; 2018.
6. Mohammed SI, Razzak Obaid AA, Majeed BA. Maternal Risk Factors and Outcomes of Premature Neonates Admitted to the Neonatal Care Unit in Al-Elwiya Pediatric Teaching Hospital in Baghdad, Iraq. Iranian J Neonatol. 2022;13(3).
7. Paudel L, Kalakheti B, Sharma K. Prevalence and outcome of preterm neonates admitted to neonatal unit of a tertiary care center in Western Nepal. J Lumbini Med Coll. 2018;6(2):87-91.
8. Sylvester MA, Mintz G, Sisti G. Maternal Outcomes Following Active vs. Expectant Management of Previable Preterm Pre-Labor Rupture of Membranes: A Meta-Analysis. Children (Basel). 2023;10(8):1347. doi: 10.3390/children10081347.
9. Sirak B, Mesfin E. Maternal and perinatal outcome of pregnancies with preterm premature rupture of membranes (pprom) at tikur anbessa specialized teaching hospital, addis ababa, ethiopia. Ethiop Med J. 2014;52(4):165-172.
10. Diriba TD, Segni H, 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; 5:163-172.
11. Poondru M, Kala R, Kumar A. Study on prevalence of prelabour rupture of membranes and its maternal and fetal outcomes. Int J Reprod Contracept Obstet Gynecol. 2021;10(11):4163-4171.
12. Assefa NE, Berhe H, Girma F, 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 childb. 2018; 18:1-7.
13. Dars S, Malik S, Samreen I, Kazi RA. Maternal morbidity and perinatal outcome in preterm premature rupture of membranes before 37 weeks gestation. Pak J Med Sci. 2014;30(3):626-629. doi: 10.12669/pjms.303.4853/
14. Choudhary M, Rathore SB, Chowdhary J, Garg S. Pre and post conception risk factors in PROM. Int J Res Med Sci. 2015;3(10):2594-2598.
15. Workineh Y, Birhanu S, Kerie S, Ayalew E, Yihune M. Determinants of premature rupture of membrane in Southern Ethiopia, 2017: case control study design. BMC res Notes. 2018; 11:1-7.
16. Aseidu EK, Bandoh DA, Ameme DK, Nortey P, Akweongo P, Sackey SO, et al. Obstetric determinants of preterm delivery in a regional hospital, Accra, Ghana 2016. BMC pregnancy childb. 2019; 19:1-8.
17. Mingione MJ, Pressman EK, Woods JR. Prevention of PPROM: current and future strategies. J Matern Fetal Neonatal Med. 2006;19(12):783-9.
18. Federal Democratic Republic of Ethiopia Ministry of Health. Management protocol on selected obstetrics topics. 2010:160-168 https://www.academia.edu/40819328/MANAGEMENT_PROTOCOL_ON_SELECTED_OBSTETRICS_TOPICS_Federal_Democratic_Republic_of_Ethiopia_Ministry_of_Health/
19. American Academy of Pediatrics and American Heart Association. Textbook of Neonatal Resuscitation. 6th edition. Elk Grove Village, IL: American Academy of Pediatrics and American Heart Association; 2011. https://www.moscmm.org/uploads/userfiles/Neonatal%20resustitation.pdf/
20. Jena BH, Biks GA, Gete YK, Gelaye KA. Incidence of preterm premature rupture of membranes and its association with inter-pregnancy interval: a prospective cohort study. Sci Rep. 2022;12(1):5714. doi: 10.1038/s41598-022-09743-3/
21. Zhou Q, Zhang W, Xu H, Liang H, Ruan Y, Zhou S, et al. Risk factors for preterm premature rupture of membranes in Chinese women from urban cities. Int J Gynaecol Obstet. 2014;127(3):254-259. doi: 10.1016/j.ijgo.2014.06.020/
22. TC O, Enwereji J, Okoro O, Adiri C, Ezugwu E, Agu P. The incidence and management outcome of preterm premature rupture of membranes (PPROM) in a tertiary hospital in Nigeria. Am J Clin Med Res. 2014;2(1):14-17.
23. Abouseif HA, Mansour AF, Hassan SF, Sabbour SM. Prevalence and outcome of preterm premature rupture of membranes (PPROM) among pregnant women attending Ain Shams maternity hospital. Egyptian J Community Med. 2018;36(2):99-107.
24. Wolde M, Mulatu T, Alemayehu G, Alemayehu A, Assefa N. Predictors and perinatal outcomes of pre-labor rupture of membrane among pregnant women admitted to Hiwot Fana Comprehensive Specialized University Hospital, Eastern Ethiopia: a retrospective study. Front Med. 2024; 10:1269024. doi: 10.3389/fmed.2023.1269024/
25. Bouvier D, Forest JC, Blanchon L, Bujold E, Pereira B, Bernard N, et al. Risk Factors and Outcomes of Preterm Premature Rupture of Membranes in a Cohort of 6968 Pregnant Women Prospectively Recruited. J Clin Med. 2019;8(11):1987. doi: 10.3390/jcm8111987/
26. Joy S, Nair S, K R. Impact of fetal presentation on pregnancy outcome in preterm premature rupture of membranes. J Clin Diagn Res. 2014;8(11): OC03-6. doi: 10.7860/JCDR/2014/9553.5114/
27. Goodman JR, Lambert AE, Peck JD, Sutton KM, Deschamps DR. Outcomes in cephalic vs noncephalic presentation in the setting of preterm premature rupture of membranes. Am J Obstet Gynecol. 2013;208(3): 231.e1-8. doi: 10.1016/j.ajog.2012.12.012/
28. Singh D, Usham R, Kamei H. Preterm prelabour rupture of membrane 1-year study. J Evol Med Dent Sci 2015; 4(49): 8495–8498.
29. Tiruye G, Shiferaw K, Tura AK, Debella A, Musa A. Prevalence of premature rupture of membrane and its associated factors among pregnant women in Ethiopia: A systematic review and meta-analysis. SAGE Open Med. 2021; 9:20503121211053912. doi: 10.1177/20503121211053912/
30. Byonanuwe S, Nzabandora E, Nyongozi B, Pius T, Ayebare DS, Atuheire C, et al. Predictors of premature rupture of membranes among pregnant women in rural Uganda: a cross-sectional study at a tertiary teaching hospital. Int J Reprod Med 2020; 2020: 1862786.
31. Hackenhaar AA, Albernaz EP, da Fonseca TM. Preterm premature rupture of the fetal membranes: association with sociodemographic factors and maternal genitourinary infections. J Pediatr (Rio J) 2014; 90(2): 197–202.
32. Laignier MR, Lopes-Júnior LC, Santana RE, Leite FMC, Brancato CL. Down Syndrome in Brazil: Occurrence and Associated Factors. Int J Environ Res Public Health. 2021;18(22):11954. doi: 10.3390/ijerph182211954/
33. Kim MS, Kim S, Seo Y, Oh MY, Yum SK. Impact of preterm premature rupture of membranes and oligohydramnios on in-hospital outcomes of very-low-birthweight infants. J Matern Fetal Neonatal Med. 2023 Dec;36(1):2195523. doi: 10.1080/14767058.2023.2195523/
34. Ocviyanti D, Wahono WT. Risk Factors for Neonatal Sepsis in Pregnant Women with Premature Rupture of the Membrane. J Pregnancy. 2018; 2018:4823404. doi: 10.1155/2018/4823404/
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Dlveen Sherzad Bahjat, Trifa Yousif Mutalib
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The copyright on any article published in AMJ (The Scientific Journal of Kurdistan Higher Council of Medical Specialties )is retained by the author(s) in agreement with the Creative Commons Attribution Non-Commercial ShareAlike License (CC BY-NC-SA 4.0)
