American Journal of Clinical Medicine Research. 2014, 2(1), 14-17
DOI: 10.12691/AJCMR-2-1-4
Original Research

The Incidence and Management Outcome of Preterm Premature Rupture of Membranes (PPROM) in a Tertiary Hospital in Nigeria

Okeke TC1, , Enwereji JO1, Okoro OS1, Adiri CO1, Ezugwu EC1 and Agu PU1

1Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital (UNTH), Enugu, Nigeria

Pub. Date: January 16, 2014

Cite this paper

Okeke TC, Enwereji JO, Okoro OS, Adiri CO, Ezugwu EC and Agu PU. The Incidence and Management Outcome of Preterm Premature Rupture of Membranes (PPROM) in a Tertiary Hospital in Nigeria. American Journal of Clinical Medicine Research. 2014; 2(1):14-17. doi: 10.12691/AJCMR-2-1-4

Abstract

Preterm premature rupture of membranes (PPROM) complicates 3-8 percent of pregnancies and leads to one third of preterm deliveries. It results in increased risk of prematurity and leads to perinatal and neonatal complications with risk of fetal death. This article aims to determine the incidence and management outcome of PPROM in Enugu, Nigeria over a ten year period. This was a retrospective review of management outcome of PPROM at the UNTH Enugu from January 1st 1999 to December 31st, 2008. The frequency of 3.3% for PPROM and 7% perinatal death were recorded over the period. Preterm PROM is a major complication of pregnancies. Currently, there is no effective way of preventing spontaneous rupture of fetal membranes due to ignorance of its aetiology, with consequent inability to control its incidence. However, it is important that women be well informed regarding maternal, fetal and neonatal complications regardless of controversies of its management.

Keywords

incidence, management outcome, preterm premature rupture of membrane (PPROM), Enugu, Nigeria

Copyright

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]  Fowlie A. Preterm pre-labour rupture of membranes, In:Arukumaran S, Symonds IM, Fowlie A (eds): Oxford Handbook of Obstetrics and Gynaecology. 2nd edition New Delhi, Oxford University Press 2004; 247-249.
 
[2]  Caughey AB, Robinson JN, Norwitz ER. Contemporary Diagnosis and Management of Preterm Premature Rupture of Membranes. Rev. Obstet Gynecol 2008;1(1):11-22.
 
[3]  Mercer BM, Goldenberg RL, Meis PJ, et al. The NICHD Maternal –Fetal Medicine Units Network, authors. The Preterm Prediction study: prediction of preterm premature rupture of membranes through clinical findings and ancilliary testing. Am J Obstet Gynecol 2000; 183: 738-745.
 
[4]  Shucker JL, Mercer BM. Midtrimester PROM. Semin Perinatol 1996;20:389-400
 
[5]  Medina TM, Hill DA. Preterm Premature Rupture of Membranes: Diagnosis and management. Am Fam Physician 2006;73:659-664
 
[6]  Borna S, Borna H, Khazardoost S, Hantoushzadeh S. Perinatal outcome in preterm premature rupture of membranes with amniotic fluid index <5(AF1>5). BMC pregnancy and childbirth 2004; 4:15.
 
[7]  Savitz DA, Blackmore CA. Thorp JM. Epidemiology characteristics of preterm delivery: etiology heterogeneity. Am J Obstet Gynecol 1991; 164: 467-471.
 
[8]  Garite TJ. Management of Premature rupture of membranes. Clin Perinatol 2001; 28: 837-847.
 
[9]  Alexander JM, Mercer BM, Miodovnik M, Thurnau GR, Goldenburg RL, Das AF, et al. The impact of digital cervical examination on expectantly managed preterm rupture of membranes. Am J Obstet Gynecol 2000; 183: 1003-1007.
 
[10]  ACOG Committee on Practice Bulletins –Obstetrics, authors. Clinical Management guidelines for Obstetrician-Gynecologists. (ACOG Practice Bulletin No 80: premature rupture of membranes). Obstet Gynecol 2007; 109: 1007-1019.
 
[11]  Mercer BM. Preterm premature rupture of the membranes: current approaches to evaluation and management. Obstet Gynecol Clin North Am 2005; 32:411-428.
 
[12]  Di Renzo GC, Roura LC. The European Association of Perinatal Medicine – Study Group on Preterm Birth, authors. Guidelines for the management of spontaneous preterm labor. J Perinat Med 2006; 34: 359-366.
 
[13]  Schrag S, Gorwitz R, Fultz–Butts K, Schuchat A. Prevention of perinatal group B streptococcal disease. MMWR Recomm Rep 2002;51:1-22
 
[14]  ACOG, authors, prevention of early–onset group B streptococcal disease in newborns (ACOG Committee Opinion: NO 279, December 2002). Obstet Gynecol 2002; 100: 1405-1412.
 
[15]  Crowley P. Prophylactic corticosteroids for preterm birth. Cochrane Database Syst Rev. 2000: 2CD000065.
 
[16]  Egarter C, Leitich H, Karas H, Wieser F, Hussiein P, Kader A, et al. Antibiotic treatment in preterm premature rupture of membranes and neonatal morbidity: a metaanalysis. Am J Obstet Gynecol 1996; 174: 589-597.
 
[17]  Meis PJ, Emen–JM, Moore ML. Causes of Low birth weights in public and private patients. Am J Obstet Gynecol 1987; 156:1165-1168.
 
[18]  Stuart EL, Evans GS, Lin YS, Powers HJ. Reduced collagen and ascorbic acid concentrations and increased proteolytic susceptibility with prelabor fetal membrane rupture in women. Biol Reprod 2005; 72:230-235.
 
[19]  Babson SG, Benson RC. Management of high risk pregnancy and intensive care of the neonate. The C.V Mosby company. 1971; 54-56.
 
[20]  Vermillion ST, Soper DE, Chasedunn-Roark J. Neonatal sepsis after betamethasone administration to patients with preterm premature rupture of membranes. Am J Obstet Gynecol 1999; 181: 320-327.
 
[21]  Yoon BH, Kim YA, Romero R, Kim JC, Park KH, Kim MH, et al. Association of oligohydramnios in women with preterm premature rupture of membranes with an inflammatory response in fetal, amniotic and maternal compartments. Am J Obstet Gynecol, 1999; 181:784-788.
 
[22]  Davidson KM, Detection of premature rupture of the membranes Clin Obstet Gynecol 1991; 34: 715-722.
 
[23]  Harding JE, Pang J, Knight DB, Liggins GC. Do antenatal corticosteroids help in the setting of preterm rupture of membranes? Am J Obstet Gynecol 2001; 184: 131-139.
 
[24]  Elimian A, Verma U, Beneck D, Cipriano R, Visintainer P, Tejani N. Histologic chorioamnionitis, antenatal steroids and perinatal outcomes. Obstet Gynecol 2000; 96:333-336.
 
[25]  Dexter SC, Pinar H, Malee MP, Hogan J, Carpenter MW, Vohr BR. Outcome of very low birth weight infants with histopathologic chorioamnionitis. Obstet Gynecol 2000; 96:172-177.