OUTCOME OF EXPECTANT MANAGEMENT OF PRETERM PREMATURE RUPTURE OF MEMBRANES

Abstract

Background: Preterm premature rupture of membranes (PPROM) is a major obstetric complication, contributing to approximately one-third of preterm births. Management strategies, particularly expectant management, remain a subject of clinical debate due to associated neonatal and maternal risks. This study aimed to evaluate the frequency of neonatal outcomes associated with expectant management in pregnancies complicated by PPROM between 24 and 36 weeks of gestation.

Objective: To determine the frequency of adverse neonatal outcomes resulting from expectant management in cases of preterm premature rupture of membranes.

Methods: A descriptive study was conducted at the Department of Obstetrics and Gynaecology, Saidu Group of Teaching Hospital, Swat, over six months. A total of 114 women with singleton pregnancies and PPROM between 24 and 36 weeks were enrolled using consecutive non-probability sampling. Expectant management included corticosteroids, tocolytics, antibiotics, and close maternal-fetal monitoring. Neonatal outcomes assessed were small for gestational age (SGA), respiratory distress syndrome (RDS), hypoxia, hypoglycemia, hypocalcemia, and admission to the neonatal intensive care unit (NICU). Data were analyzed using SPSS v26.

Results: The mean maternal age was 29.4 ± 6.2 years, with a mean gestational age of 30.7 ± 3.4 weeks. Among neonates, 34.2% were SGA, 42.1% developed RDS, 43.9% experienced hypoxia, 17.5% had hypoglycemia, and 11.4% had hypocalcemia. NICU admission was required in 36.8% of cases. These findings align with published literature, reinforcing the clinical feasibility of expectant management when conducted with strict surveillance.

Conclusion: Expectant management of PPROM, under controlled monitoring, is a viable strategy to improve neonatal outcomes by prolonging gestation and allowing fetal maturation, though it carries significant risk of prematurity-related complications.