Comparison of the effect of Premature Rupture of Membranes in two passive and active stages of labor on maternal and neonatal outcomes: a population-based prospective cohort study

Background: Premature rupture of membrane (PROM) may occur before or after the onset of labor pains at any age of pregnancy and cause maternal and neonatal consequences. The aim of the study was to investigate the effect of the time of rupture of the fetal membranes on the short-term and long-term outcomes of the mother and the baby.

Materials and methods: The present study is a cohort study that was conducted in the period of 2016-2019 on 775 pregnant women with a gestational age of 37 weeks and above who had referred to Kausar Hospital for delivery and met the study inclusion criteria. Checklists were completed in 5 stages (immediately after delivery, first 24 hours after delivery, one month, one year and two years after delivery). The data was analyzed with SPSS version 25 software.

Results: Mothers with PROM in the latent phase compared to the active phase had higher morbidity in the first month after delivery (0.49, 0.32 HR=0.76, P=0.001). Neonatal complications in the first 24 hours (0.20, 0.84) HR=0.41, P=0.015 and in the first month after delivery (0.04, 0.71) HR=0.17, P=0.016 was higher in the group of PROM in the latent phase than in the active phase. With PROM in the latent phase, the rate of cesarean delivery and episiotomy was 0.18 higher.

Conclusion: The results showed that with the increase in the duration of PROM, the possibility of complications increases. Therefore, shortening the duration of delivery in term pregnancies is better than expectant management in preventing complications