Maternal, Fetal and Neonatal Outcomes in Mothers With Diabetes Mellitus or Gestational Diabetes That Complicated With Preterm Premature Rupture of the Membrane (PPROM)

Abstract

Objectives: It has been suggested that the presence of diabetes may increase the possibility of occurrence of premature rupture of the membrane (PPROM), which in turn, could lead to a dramatic escalation in the rate of pregnancy-related complications. The available data, however, are not sufficient in this regard in the literature. This study aims to examine pregnancy outcome in pregnant women with simultaneous diabetes mellitus/gestational diabetes and PPROM. Materials and Methods: A total of 134 pregnant women with gestational diabetes (n = 99) or diabetes mellitus (n = 35) were compared with 135 pregnant women normoglycemic women in terms of maternal, fetal and neonatal outcomes in a teaching hospital. Multiple-pregnancy, anomalous fetus, complicated pregnancies, polyhydramnios, placental problems, and intrauterine growth restriction were exclusion criteria. Results: The three groups were comparable for the incidence of cesarean section, labor induction, chorioamnionitis, postpartum hemorrhage, need for ICU/NICU admission, placental retention, transfusion requirement, neonatal infection, respiratory distress, need for resuscitation, icterus, dystocia, need for insulin injection, and maternal/fetal mortality, as well as the mean Apgar and neonatal hospital stay. The mean maternal hospital stay and the duration of vaginal delivery were significantly shorter in controls than in patients with gestational diabetes. The rate of neonatal hypoglycemia was significantly higher in the group with diabetes mellitus compared to that in the two other groups. Conclusion: Except for the maternal hospital stay, duration of vaginal delivery and the incidence of neonatal hypoglycemia that were significantly better in normoglycemic mothers, the three groups were comparable for the remaining outcome variables.