COMPARE THE PERINATAL/EARLY NEONATAL MORBIDITY AND MORTALITY IN WOMEN WITH PPROM RECEIVING BED REST WITH THE WOMEN RECEIVING ACTIVITY DURING PREGNANCY

Abstract

Background: Preterm premature rupture of membranes (PPROM) i.e. rupture of membranes before 37 weeks of gestation. It can lead to significant perinatal morbidity and is associated with 18-20% of perinatal deaths. Perinatal morbidity results due to infection, cord
compression, placental abruption and prematurity. Management of PPROM is a challenging problem and it depends on the gestational age and fetal status. Methodology- The study was carried out in the Department of Obstetrics & Gynaecology, UCMS & GTB Hospital, Delhi from November 2013 to 30 July 2016. A total of 60 patients were included in the study and were randomized in 1:1 ratio with the help of centralized computer randomization (Group-1: Bed rest group Group-2: Activity group). Detailed history pertaining to risk factors were taken. Diagnosis of PPROM was confirmed by sterile speculum examination. All the patients were managed as per hospital protocol and admitted till delivery. Maternal demographic and obstetrics data and neonatal outcomes were compared between groups using independent ttest, Fisher’s exact test, and Chi-square test. Result- Neonatal outcome included G.A., NICU stay, birth weight, Apgar 1 min and 5 min, neonatal morbidity like RDS, sepsis, NEC, and neonatal mortality. The mean NICU stay in bed rest group was 6 days 3 hour±6 days 1 hour and in activity group was 4 days 22 hour±5 days 1 hour (p-value=0.56). Neonatal mortality
occurred 6 cases in bed rest group and 12 cases in activity group. Conclusion- There is no significant effect of bed rest on early neonatal parameters like G.A. (gestational age) at the time of delivery, birth weight, Apgar (1 min. & 5 min.), and NICU stay. Composite neonatal morbidity like RDS, sepsis, NEC (necrotizing enterocolitis) is not affected by activity. There was increased neonatal mortality in activity group, however this was not statistically significant