Epidemiology of preterm premature rupture of fetal memranes(PPROM) at the University Teaching Hospital, Lusaka

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Silwimba, Willies
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Background: Preterm premature rupture of membranes (PPROM) is the main cause of preterm delivery and is associated worldwide with increased rates of neonatal and maternal morbidity and mortality (Parry et al 1998, Joseph et al 1998). The aim of this study was to determine the epidemiology of preterm premature rupture of membranes at UTH, Lusaka.Methods: The study population was pregnant women admitted to the University Teaching Hospital from February 2013 to July 2013 with confirmed diagnosis of PPROM. A questionnaire was used to collect data and medical records were reviewed for extra information. In addition, sterile speculum vaginal examinations were done and endorcervical swabs were collected for microscopy and culture. Results: Of the 100 women with PPROM that were enrolled, only data for 97 patients was analysed as three patients were lost to follow up. Of the endocervical swabs collected, 62.9% had positive cultures of which Candida sp (n=11, 18%) was the most common organism to be isolated followed by Escherichia coli (n=8, 13.1%) and enterobacter cloace (n=7, 11.5%). Multiple logistic regression analysis showed that poor fetal outcome was associated with a gestation age of <34 weeks (OR 18.77, 95% CI 1.87 -188.62) and birth weight of <1500g (OR 281.17, 95% CI 12.47 – 6338.97). A caesarean delivery had a tendency towards reducing poor fetal outcome (OR 0.01, 95% CI 2.33- 0.7 P = 0.033.) Conclusion: Low birth weight and low gestation were associated with poor fetal outcomes in mothers with PPROM