الفهرس 
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Abstract
Premature rupture of membranes (PROM) also called pre-labor rupture of membranes , is a condition that can occur in pregnancy . it is defined as rupture of membranes ( breakage of amniotic sac ).
Preterm premature rupture of the membranes (PPROM) is defined as loss of amniotic fluid before the onset of labor in pregnancies before 37 weeks of gestation, which is characterized as a painless flow of fluid that escapes out of the vagina .
PROM is a serious condition leading to approximately one-third of preterm births and it complicates about 3% of pregnancies .
The exact etiology is vague , but usually the cause is multifactorial , depending on special anatomy of the fetal membranes , protecting factors and factors that lead to weakening and destruction of the membranes .
There are many studies suggesting that maternal nutritional deficiency , certain connective tissue disorders , cervical incompetence , smooking , sexual activity and genital tract infection predispose to PROM .
The present study was done in Minia governorate ,Minia Maternity university hospital which serve as tertiary care facility for whole Minia Governorate , where there are approximately 12.500 deliveries annually . During the period from 1st october 2019 to 31th march 2020 . 456 patients with Premature Rupture of Membranes were included . This study was approved by the hospital’s Ethical Committee .
Results are summarized as follows :
Prevalence of PROM among women delivered at Minia maternity university hospital during the study period was 7.4% .
The mean age of patients was 26.4 year ranged between 18 to 48 years . Gestational age mean of all cases was 33.8 week at PROM ranged from 24-37 weeks, primigravida were 140 cases (30.7%) of the patients, However multigravida were 212 cases (46.5%) of the patients , and Grand multi gravida were 104 cases (22.8%) of the patients , patients with singleton pregnancy were 389 cases (85.3 %) of the patients , The majority of women were housewives (78.7%) and most of patients presented with gush type of rupture membrane (73.7%) & (79.6 %) of the patients went into spontaneous labor within 24 hours and (51.1 % ) delivered by CS. About 325 cases (71.3%) of the patiens had preterm baby . The majority of women didn’t have a previous history of PROM (94.5%) and most of them were free from chronic diseases (81.8%) , Low percentage of women developed chorioamnionitis (3.7%) , (1.8%) of the patients had placental abruption , (1.5%) of the patients had infected wound after CS and (1.1%) of the patients had post partum hemorrhage .
As regards fetal/neonatal outcome; (73.9 %)of patients had infants with good fetal outcome (alive & well). And (26.1 %) of patients had infants with poor fetal outcome including; ,while 81 cases (17.8%) of the patients had Alive and ill babies from which about 67 cases (14.7%) of the patients had NICU admission, 79 cases (17.3%) of the patients had respiratory distressed babies and only 4 cases (0.8% ) of the patients had fetus with congenital anomalies , 8 cases (1.8%) of the patients had Neonatal infection and 8 cases (1.8 %) of the patients had IUGR . while fetal perinatal death 38 cases (8.3%) of the patients including 12 cases (2.6%) of the patients had IUFD ; 26 cases (5.7%) of the patients had END .About 290 cases (63.6%) of the patients had babies with Low birth weight ≤ 2.5kg .
from the previous result it can be concluded that :
Antenatal diagnosis to prevent PROM by identifying the risk factors is a important tool in management.
Premature rupture of the membranes (PROM) is associated with considerable perinatal morbidity and mortality and significant maternal morbidity .
Regarding obstetric history of pregnant women; mean gestational age at PROM & at delivery, type of rupture of membranes, history of chorioamnionitis and mode of delivery were significantly related to poor fetal outcome (p value < 0.05).
These results suggest that the women employment ,gush type of PROM, delivery by CS and earlier gestational age at PROM were significant independent predictors of poor fetal outcome.
The earlier the occurance of PROM and the longer the interval between the rupture of fetal membranes and onset of labour , the more complications there are likely to be happened.