Delivery in women with premature rupture of membranes (PROM)

Introduction. Premature rupture of membranes (PROM) and amniotic fluid outflow indicates discontinuation of physiological bariers protecting the foetus against harmful environmental factors. PROM ethiology remains unexplained, it is considered that the main risk factor is going through premature delivery in the past, especially preceded by PROM, or delivery loss due to miscarriages. The aim. The aim of the article was to present complications and outcome of deliveries in the group of women with PROM. Materials and Methods. A group of 62 women with PROM, was compared to a group of 100 women with preserved membranes. Results. A mean age in both groups was similar (27,1 and 26,4 year), the most of the women were nulliparas. The percentage of preterm deliveries was higher in the PROM group (35,5% versus 24%) and the average time of pregnancy was shorter (35,8 vs 38,4 weeks). The frequency of pregnancy lost in the past was similar in both groups, so as a percentage of IUGR, GDM and placenta praevia. PIH was more common in the control group, but threatening preterm delivery and intrauterine infection in the PROM group. Beginning a delivery 64,5% of women with PROM had unprepared cervix (<6 in Bishop score) . The percentage of induction of delivery according to intrauterine infection was higher, so as a percentage of caesarean sections (48,4% versus 38%), the most common reason for them were fetal asphyxia and insufficient progress of delivery. The mean time of the first stage of delivery was similar in the both group, but the second stage was twice shorter in the PROM group and the newborns’ weight lower. There were no differences between the average newborns’ condition in 1 minute Apgar score. Conclusion. Intrauterine infection is the most dangerous complication connected with PROM. Women with prom have more often unprepared cervix when a delivery begins, induction of delivery due to the intrauterine infection is performed more often and a higher percentage of caesarean sections is observed in this group