TITLE:
Support Epidemiology and Prognosis of Premature Rupture of Membranes in Pikine National Hospital Center
AUTHORS:
Moussa Diallo, Abdoul Aziz Diouf, Hadja Maimouna Barro Daff, Natty Seck, Aminata Niass, Youssou Toure, Khalifa Fall, Codou Sene Seck, Alassane Diouf
KEYWORDS:
Premature Rupture of Membranes, Childbirth, Stillbirth, Chorioamnionitis
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.9 No.11,
November
19,
2019
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.