Abstract
Premature rupture of membranes (PROM) complicates 3% of preterm pregnancies and occurs in 60% to 80% of term pregnancies. However, its management remains largely controversial. The objective of this study was to establish the epidemiological profile, to study the management and the prognosis of Premature rupture of membranes (PROM) in our practice. Patients and methods: It was a prospective, descriptive and analytical study from May 1st 2016 to January 31st 2017 at the Pikine National Hospital Center. The target population consisted of all patients received at the hospital with premature rupture of membranes and who had given birth in the structure. The variables studied were: marital status, mode and reason for admission; risk factors; antecedents; prenatal care; the clinical and paraclinical examinations; support and immediate maternal and fetal neonatal complications. Results and comments: The mean maternal age was 27.34 years and the majority of women were aged between 18 and 39 years (94.4%). Fifty-one point three percent of patients were primiparous, large multiparous represented only 2.5%. The majority of patients (385 patients or 66.9%) had consulted in the first 12 hours following the onset of fluid flow. For 20.1% of them this flow was associated with uterine contractions. Hidden risk factors were dominated by the twin pregnancy. The blood count showed that 38.8% of patients had leukocytosis and CRP was positive in 18.3% of patients. An ampicillin-based antibiotics was established in 42.6% of cases, corticosteroid therapy in 5.2% and 1% in tocolysis. An expectation was adopted in 65.7% of cases, induction of labor in 7.3% and a cesarean section immediately in 27% of cases. In total, 65.7% of patients had vaginal delivery and 34.3% cesarean. The perinatal mortality rate was 3.6% or 22 newborns on 610. Two cases of endometritis were observed and one case of immediate postpartum hemorrhage. No maternal deaths were recorded. Conclusion: These results show that the prognosis of premature rupture of membranes remains favorable in our practice. To improve this prognosis, we recommend sensitization of patients during prenatal care regarding signs of danger, a systematic bacteriological sample from all pregnant at the end of their pregnancy and the health personnel to direct patients’ references to structures in case of PROM.
Highlights
Premature rupture of membranes (PROM) is a relatively frequent pathology obstetric complicating 3% of preterm pregnancies [1] and occurring in 60% to 80% of term pregnancies [2]
The target population consisted of all patients received at the hospital with premature rupture of membranes and who had given birth in the structure
These results show that the prognosis of premature rupture of membranes remains favorable in our practice
Summary
Premature rupture of membranes (PROM) is a relatively frequent pathology obstetric complicating 3% of preterm pregnancies [1] and occurring in 60% to 80% of term pregnancies [2]. It corresponds to an opening of the amniotic membranes before labor begins. Other risk factors can be personal (age, parity, bad socioeconomic conditions, medical history), constitutional (uterine malformations: hypoplastic uterus) or traumatic. His diagnosis is easy and is based, in most cases, on an interview and a thorough clinical examination. Its aim is to improve maternal-fetal and neonatal prognosis minimizing complications of prematurity and infection
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