Document Detail


Pre-term premature rupture of fetal membranes: the dilemma of management in a developing nation.
MedLine Citation:
PMID:  17365456     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This study aims at evaluating the outcome of pregnancies complicated by pre-term premature rupture of membrane (PPROM) in a developing country and to highlight the problems of managing such cases and ways of improving future management. This was a retrospective review of 344 patients with PPROM at a University of Nigeria Teaching Hospital Enugu, Nigeria over a 10-year period (January 1994-December 2003). The prevalence of PPROM in this study was 25 per 1,000 births and patients of low parity (para 0-2) accounted for the highest number (56.4%). Previous abortion was significantly more among these women of low parity and may be a factor in the aetiology of PPROM. The gestational age range 28-30 weeks recorded the highest incidence (29.7%) of PPROM. The most common associated aetiological factor was cervical incompetence (11.6%), while chorioamnionitis, a major complication in the patients showed a statistically significant reduction with early antibiotic administration (p<0.05). About 72% (n=248) of the patients arrived at the hospital within 24 h of membrane rupture. Perinatal mortality was high (520 per 1,000 births) due to prematurity and perinatal infections. Better fetal outcomes were recorded among patients with PPROM at gestational age above 30 weeks, fetal weight above 2 kg, normal delivery, absence of maternal infection and latent period of not more than 5 days (p<0.05). The parity of the women did not significantly affect fetal outcome (p>0.05). Two (0.6%) maternal deaths were recorded. Prompt patient referral, early institution of antibiotics and improvement of neonatal facilities in tertiary health institutions in developing countries is advocated as a way of improving fetal survival in PPROM.
Authors:
S N Obi; B C Ozumba
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology     Volume:  27     ISSN:  0144-3615     ISO Abbreviation:  J Obstet Gynaecol     Publication Date:  2007 Jan 
Date Detail:
Created Date:  2007-03-16     Completed Date:  2007-05-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8309140     Medline TA:  J Obstet Gynaecol     Country:  England    
Other Details:
Languages:  eng     Pagination:  37-40     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Enugu, Nigeria. nobis@rbow.net
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MeSH Terms
Descriptor/Qualifier:
Developing Countries*
Female
Fetal Membranes, Premature Rupture / therapy*
Humans
Nigeria
Pregnancy
Pregnancy Outcome
Retrospective Studies
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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