Author(s)

Roger Mbungu Mwimba¹, Anselme Mbungu Mulaila¹, Joëlle Lumaya Ambis¹, Andy Mbangama Muela¹, Adrien Tandu Umba¹, Berry Kinkenda Nsiangangu¹, Malka Salamo Azama¹, Thérèse Biselele Bakambuvua², Kahindo P. Muyayalo^1,3*

¹Department of Obstetrics and Gynecology, University of Kinshasa, Kinshasa, Democratic Republic of the Congo.
²Neonatal Unit, Department of Pediatrics, University Hospital of Kinshasa, Democratic Republic of the Congo.
³Institute of Reproductive Health, Center for Reproductive Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Premature Rupture of Membranes (PROM) with the resulting prematurity remains a major public health issue in the Democratic Republic of Congo (DRC). This study aimed to assess expectant management of PPROM before 34 weeks at the university hospital of Kinshasa. We conducted a retrospective analysis of expectantly managed PROM before 34 weeks between January 2008 and December 2018. Maternal and fetal outcomes were collected, and all data were analyzed using the SPSS 23.0 software. Of the 113 patients included in the study, 2.6% were diagnosed with PROM before 34 weeks. We observed prolongation of the pregnancy duration; the median latency period was eight days, and the average gestational age at delivery of 32.85 ± 2.5 weeks. Chorioamnionitis (23%), severe oligoamnios (7%), and acute fetal distress (4%) were complications observed during the latency period. In the postpartum period, endometritis (6.2%), neonatal jaundice (39.8%), anemia (25.7%), ulcerative necrotizing enterocolitis (6.2%), cerebromeningeal hemorrhage (5.3%), and acute respiratory distress syndrome (4.4%) were complications observed. The risk of infection during the latency period was significantly associated with irregular (P = 0.045) or lack (P = 0.006) antenatal care (ANC) attendances and C-Reactive Protein (CRP) results < 6 (P = 0.013). The risk of neonatal death was significantly associated to infection during the latency period (P = 0.011), irregular (P = 0.009) or lack of ANC (P = 0.000) attendances, Birth weight <1000 g (P = 0.039) as well as Gestational age at birth between 28 to 30 Weeks (S) (P = 0.021). These findings report first-time pregnancy outcomes related to the management of PPROM before 34 weeks in our setting. We found that the conservative attitude adopted allowed the prolongation of pregnancies, reducing the risks associated with prematurity. Nevertheless, attendance in good quality ANC could reduce the frequency of PROM and related adverse outcomes.

Premature Rupture of Membranes, Gestational Age, Expectant Management, Pregnancy Outcomes, D. R. Congo

Mwimba, R. , Mulaila, A. , Ambis, J. , Muela, A. , Umba, A. , Nsiangangu, B. , Azama, M. , Bakambuvua, T. and Muyayalo, K. (2022) Expectant Management of Preterm Ruptured Membranes before 34 Gestational Weeks at the University Hospital of Kinshasa, a Tertiary Referral Hospital in the Democratic Republic of Congo. Open Journal of Obstetrics and Gynecology, 12, 633-648. doi: 10.4236/ojog.2022.127057.