Determinants and Outcome of Preterm Premature Rupture of Membranes at a Tertiary Facility in North central Nigeria

Abstract

Background: PPROM is the spontaneous rupture of the foetal membranes during pregnancy, after the age of viability but before 37 weeks gestation in the absence of regular painful uterine contractions. PPROM is a significant contributor to preterm births and perinatal morbidity and mortality.

Aim: To determine the prevalence, maternal and foetal outcome of PPROM in UITH, Ilorin, Nigeria.

Methods: This was a 5-year retrospective study of PPROM at the UITH Ilorin, Nigeria between January 1, 2016 and December 31, 2020. Data were retrieved from wards reports of women treated for PPROM during this period. Data were analysed using IBM-SPSS, 25.0.

Results: The mean age of women treated for PPROM was 30.05 ± 6.32 years. During the period, a total of 3501 deliveries were recorded, with a PPROM prevalence of 3.2%. The identifiable risk factors for PPROM were previous history of PPROM (32.1%), bacterial vaginosis (8.0%), short inter-pregnancy interval of <18months (7.1%) and cervical incompetence (4.5%). Majority of the preterm neonates born following PPROM had favourable outcome, 82.1% of them survived, and 17.9% suffered perinatal mortality. Majority (78.6%) of the women experienced various complications ranging from chorioamnionitis (31.3%), postpartum haemorrhage (15.2%), puerperal pyrexia (17.9%), puerperal sepsis (3.6%) and depression (9.8%). Highest perinatal mortality was recorded among neonates delivered between 28 weeks to 30 weeks+6 days GA, and mortality rate of 10.7% with case fatality rate of 37.5%. Among neonates born at 34-36 weeks+6days GA, a mortality rate of 1.78% and case fatality of 7.40% was recorded.

Conclusion: This study provides evidence-based result on the impact of PPROM on maternal and foetal outcome. PPROM is a major complication of pregnancies, therefore studies to find effective ways of preventing PPROM with consequent reduction in its prevalence is recommended.