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Abstract Premature rupture of membranes (PROM) constitute one of the most important dilemmas in current obstetric practice .the term is applied to leakage of amniotic fluid in the absence of labor irrespective of gestational age .( PROM) before (37) weeks gestation is referred to as preterm premature rupture of membranes (PPROM ). overall ,about (10%) of all gestations are complicated by (PROM). At term, the incidence of PROM varies from 6 to 10%. Nearly all women with(PPROM) will eventually deliver before term, and the majority of these women will deliver within one week of rupture regardless of their gestational age at the time of membrane ruprture. Premature Rupture of Membrane (PROM) is one of the most common complications of pregnancy that has a major impact on neonatal mortality and morbidity. Premature rupture of membranes(PROM) is associated with a series of adverse maternal and neonatal out comes so, It turns a pregnancy into a high-risk situation and increases the need for neonatal resuscitation in the delivery room. The occurrence of PROM is either directly or indirectly responsible for a large number of premature births and the concomitant mortality and morbidity associated with preterm delivery. The incidence of neonatal sepsis increases with PROM, but the overall out come of the neonate is still primarily dependent on the gestational age at the time of delivery. Premature Rupture of the fetal membranes is one of the most common and controversial problems facing the obstetric clinician. It may lead to various complications including maternal and fetal neonatal infection, premature labour and delivery, hypoxia, and asphyxia PDF Creator: PDF4U Pro DEMO Version. If you want to remove this line, please purchase the full version Summary 125 secondary to umbilical cord compression, increased caesarean section rates, and fetal deformation. The purpose of this study was to assess the role of the nurse in management of premature rupture of membrane (Routine care) and to assess the effect of Nursing management for women with premature rupture of the membrane on the maternal and neonatal out comes. The study was conducted at two Hospitals in Menoufiya governorate. These hospitals were Quisna general hospital and Menoufiya Univerisity Hospital. The total sample was 60 women with premature rupture of membranes. To be able to achieve the aims of the study, the inclusion criteria of these women included in the study sample were : § Full term delivery 37 weeks gestation, § both primipara and multipara were included, § not diagnosis with fetal disease, § premature rupture of membrane, § cephalic presentation and singleton gestation. The sample of the study was randomly assigned into two groups, a study group and a control group. The methods of data collection included an interviewing questionnaire sheet, Assessment sheet for the mother, Partograph sheet, A pgar score to asses the condition of the neonate, Post partum assessment sheet for both mother and baby, and nurses observational chick list for assessment of nurses intervention for women with (P.R.O.M). The study revealed that the mean age of the women ranged from 26.2 to 28.7 years. About half of the sample (46.7%) has secondary education, while near one quarter of the women (23.3%) were illiterate, and about one quarter of the women (30%) has University education. The PDF Creator: PDF4U Pro DEMO Version. If you want to remove this line, please purchase the full version Summary 126 study has indicated that the majority of the women (64%) were house wives, while (36%) of women were employee and working. And near to three quarter (71.5%) of women were multi Para, and only (28.5%) were primigravida & Para. The study has indicated also that, there are no cause to the PROM in the majority of women (70%) of the study sample, while (30%) had causes of PROM as, the coitus during the last week of the pregnancy, polyhydramnious, Abnormal fetal presentation or malposition, cervical cerculage and leucorrhea. The study revealed that, the nurses scores in their intervention with women with PROM ranged from (62.9) in the study group to (68.6) in the control group. The Majority of nurses (60%) had fair scores while more than one fourth (30%) of the nurses had good scores in their intervention. According to the study findings, the Mean duration of the first stage of labor ranged from (5.23+4.23) to (5.46+5.73) hours, while the mean duration of the second stage of labor ranged from (20.86+18.6) to (23.33+21.2) minutes. And the mean duration of the third stage ranged from (12.66+10.14) to (13.33+13.5) minutes. According to the study findings, the Majority of the women (70%) in the study group and (50%) in the control group had normal vaginal deliveries.While the lower percentage of cesarean section deliveries (30%) was in the study group, than (43.3%) in the control group and very law percentage (6.6%) had instrumental deliveries. The study has revealed that, the Maternal complications during labor were (10%) in the study group, while it was (30%) in the control group. However, the infant’s complications during labor was (63.3%) in the study group and very high in the control group (93.3%). These differences were statistically significant regarding cyanosis and Respiratory Distress syndrome. PDF Creator: PDF4U Pro DEMO Version. If you want to remove this line, please purchase the full version Summary 127 According to the study findings. The lower Apgar scoring during the first minute (5.8) score was in the control group, while it was (6.6) score in the study group. But at the fifth minute, there is an improvement in the Apgar scores, it was (7.8) score in the control group and (8.7) score in the study group. Also, the study explained that the NICU Admission was high (20%) in the control group and very low (6.6%) in the study group. Based on the study findings, the following is recommended: § Preventive measures about PROM should be instructed for the pregnant women who are at risk for PROM during antenatal care visits. § Women who have predisposing factors or risk factors for PROM should be hospitalized two weeks before delivery as they are considered high risk. § In service training for nurses working in labor units (areas that nurses had shortage in) in the following topics: use of pantograph, immediate care of the newborn, and Apgar score. § Labor wards should be provided with electronic maternal and fetal monitoring in order to detect any abnormalities of uterine contractions at first and second stages of labor, and fetal heart rate (F H R) pattern. § Similar research should be carried on a large number of cases to be able to generalize the findings of the study. § The pediatrician should be present during labor of (PROM) cases to carry out immediate baby care and receive the newborns correctly and safely. |