Fetomaternal Outcomes in Preterm Prelabour Rupture of Membranes: A Descriptive Case Series from a Tertiary Care Hospital

Abstract

Background: Preterm prelabour rupture of membranes (PPROM) is a major contributor to preterm births and is associated with significant neonatal and maternal morbidity. Despite its clinical relevance, the pattern and frequency of fetomaternal outcomes in PPROM vary across populations, with limited data from local tertiary care settings in Pakistan, thereby necessitating context-specific evidence. Objective: To determine the frequency of fetomaternal outcomes—including cesarean section, postpartum haemorrhage, birth asphyxia, stillbirth, neonatal sepsis, necrotizing enterocolitis, and respiratory distress syndrome—in patients diagnosed with PPROM. Methods: This descriptive case series was conducted at the Department of Obstetrics and Gynaecology, Lady Reading Hospital, Peshawar, over six months. A total of 168 pregnant women aged 18–40 years with singleton pregnancies between 24–36 weeks of gestation and diagnosed with PPROM were enrolled through non-probability consecutive sampling. Patients with established labour, fetal anomalies, or intrauterine fetal death were excluded. Data were collected using a structured proforma, and outcomes were monitored until five days postpartum. Ethical approval was obtained, and the study adhered to the Declaration of Helsinki. Data were analyzed using SPSS v22 with chi-square tests applied post-stratification; p ≤ 0.05 was considered statistically significant. Results: The mean maternal age was 28.6 ± 2.53 years, mean gestational age was 30.16 ± 1.97 weeks. Cesarean section was performed in 19.6% of cases, postpartum haemorrhage occurred in 5.4%, birth asphyxia in 8.3%, and stillbirth in 7.7%. Neonatal sepsis (14.3%), necrotizing enterocolitis (12.5%), and respiratory distress syndrome (42.9%) were the most prevalent neonatal complications. None of the outcomes showed statistically significant associations with age, gestational age, parity, or socioeconomic status. Conclusion: PPROM is associated with a high burden of neonatal complications, particularly respiratory distress syndrome and sepsis, and a notable cesarean section rate. Early identification, individualized management, and context-specific care strategies are essential to improve fetomaternal outcomes in such cases.