IMPACT OF APPLYING QUEENSLAND CLINICAL GUIDELINES ON MATERNAL OUTCOMES AMONG WOMEN WITH PRETERM PRELABOUR RUPTURE OF MEMBRANES

Abstract Background: Preterm prelabour rupture of membranes (PPROM) is the spontaneous rupture of fetal membranes before 37 weeks of gestation but also before the onset of labor. PPROM can lead to significant maternal complications such as placental abruption, operative delivery, chorioamnionitis, primary postpartum haemorrhage, and puerperal infections. Therefore, the aim of this study is to examine the impact of applying Queensland Clinical Guidelines during the period of expectant management on maternal outcomes among women with preterm prelabour rupture of membranes. Design: A quasi-experimental design (Nonequivalent control group posttest- only design) was adopted. The study was conducted at inpatient department of antenatal care in El-Galaa Teaching Hospital, which is a governmental hospital affiliated to the General Organization for Teaching Hospitals & Institutions- Egyptian Ministry of Health and Population, Cairo. Sample: A total of 110 pregnant women having PPROM were recruited, a control group of 55 women were followed up first, and then 55 women of study group were enrolled to intervention. Tools: (A) Structured interview schedule; (B) Monitoring and follow up tool for PPROM based on Queensland Clinical Guidelines; and (C) Evaluation of pregnancy outcomes tool. Results: Initial assessment revealed no significant difference between the study and control groups in mean gestational age (p=0.602), amount of amniotic fluid (p=0.567), vital signs, WBCS count, and amniotic fluid color and odor. The rate of chorioamnionitis and emergency CS was lower among the study group than the control group with a significant difference between the two groups (p= 0.007& p= 0.004 respectively). The mean GA at delivery and latency period was higher among the study group than the control group with a significant difference between the two groups (p = 0.002, p = 0.021 respectively). Incidence of postpartum hemorrhage was 0:3 in the study group versus control group; also, puerperal sepsis was 0: 5 in the study group versus control group. Conclusion: Application of queensland clinical guidelines for women with PPROM that includes advise about: the risk of infection and how to prevent it, when to seek care from a health care professional, and the risk of cord prolapse and emergency management if occurs had a significant effect on reducing maternal complications (such as chorioamnionitis, emergency caesarean section delivery, primary post-partum hemorrhage, and puerperal sepsis). Recommendations: Integrating queensland clinical guidelines for PPROM as a main part of antenatal guidelines for care of women with PPROM.