Incidence and Management of Chorioamnionitis in Cases with Preterm Rupture •of Membranes.

Abstract

This study was carried out to evaluate the efficacy and time gained by expectant management and related complications in cases with Preterm rupture of membranes (PROM) and the incidence of chorioamnionitis. This included prospective study of 35 cases with PROM, in labour, with no signs or symptoms of chorioamnionitis and with no contraindications to conservative management, Over a period of 33 months from March 1993 to December 1995. Incidence of PROM was found to be 0.2% of all hospital deliveries. Previous history of PROM was evident in8.57% of patients and 17.14% of patients had fever due to other causes. High vaginal swab revealed E. Coli as most common organism in 22.85% of cases. Antibiotics were not prescribed in 42.85% of patients, while 25.75% cases received ampicillin alone. Prolongation of pregnancy achieved was 38 days in one (2.85%) case, who delivered a fetus with pressure deformities. Another patient had 30 days prolongation with conservative management with no complications. Ten patients developed clinical chorioamnionitis. Eighty percent patients had spontaneous delivery and 20% underwent caesarean section. None of the new born babies developed sepsis. Only 2 patients developed postpartum fever. Expectant and conservative management can be adopted safely in cases with PROM along with meticulous fetal and maternal monitoring and without extra risks to the fetus or the mother.