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CHAPTER 1
INTRODUCTION

Premature rupture of the membranes (PROM) is one of the most common
complications of pregnancy. It occurs in approximately 10% of all pregnancies
and is causally related to increased incidence of perinatal death rate, fetal distress
during labor, and infection (fetal and maternal), However, one of the most
common complications in PPROM patients is intrauterine infection, which can
lead to chorioamnionitis, metritis after delivery and perinatal outcome such as
neonatal sepsis. Other complications are cord prolapse during rupture of
membranes and placental abruption. Since amniotic fluid has certain bacteriostatic
properties which protect against potential infection, it seems that a decrease in
amniotic fluid volume may impair the pregnant womens ability to combat such
infections and cause an increased risk of infection. Two variables that are
available at the time of membrane rupture have major prognostic implications
gestational age at rupture and residual amount of amniotic fluid.
1,2

Oligohydramnios complicates 37% to 45% cases of PROM. Decreased
initial amniotic fluid volume following PROM has been consistently associated
with decreased latency. Severe oligohydramnios in early pregnancy, therefore,
may lead to the underdevelopment of fetal lung tissue (pulmonary hypoplasia) and
limb defects and is associated with poor fetal growth. There is also an increased
risk of miscarriage, premature birth and stillbirth. Furthermore oligohydramnios
could cause fetal distress due to compression of the umbilical cord.
Oligohydramnios is found to be associated with an increased risk of caesarean
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delivery for fetal distress, low Apgar score and high perinatal morbidity and
mortality. Apart from that, they also suffer from other kinds of congenital
anomalies, they are as follows: pulmonary hypoplasia, Club foot, pres cavus, pres
pitus, cardiac problem, nodular skin, coccygeal teratoma, Sickle
call anemia
2,3
Premature rupture of the membrane have many complications in the
outcome of the pregnancy such as placental abruption, malpresentation, umbilical
cord prolapse, sequelae of prematurity, and infection (chorioamnionitis,
endometritis, and neonatal sepsis).
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Just like PROM, oligohydramnion play an
important role to the outcome of the pregnancy.