Prevalence of Preterm Prelabour Rupture of Fetal Membranes and Neonatal Outcome at the Gambian Tertiary Hospital

Preterm prelabour rupture of membranes (PPROM) is one of the major factors that have been found to correlate with adverse pregnancy outcome. It remains a critically important clinical and public health problem. PPROM occurs in 1-3% of pregnancies and causes around 25-30% of all preterm deliveries and is the leading identifiable cause of preterm deliveries. The knowledge of prevalence and neonatal outcome in our setting may certainly inform practice.

Methodology: A cross sectional descriptive study was conducted at Edward Francis Small Teaching Hospital (EFSTH) Banjul from January 1st 2015 to December 31st 2017. All pregnant women admitted on the labour ward with spontaneous rupture of fetal membranes before 37 completed weeks of gestation were included. Data was collected from the registers and entered into SPSS version 20. The results were expressed in descriptive statistics by simple percentage and test of significance was by Chi‑square with error margin set at 0.05 and confidence interval of 95%.

Results: There were 5835 deliveries recorded from January 2015 to December 2017. Seventy eight (78) were cases of preterm PROM. This showed a prevalence of 1.3% for PPROM. PPROM was more common among age group 26-30 years (mean of 28 years); multigravida (75.0%); gestation age 29-32 weeks (51.7%); housewives (51.7%). Majority (58.3%) had a latency period of 72hours and above. Vaginal birth occurred in 83.3% and 16.7% had caesarean section. The stillbirth rate was 8.3% and live birth rate was 91.7%. There was no significant difference (p-0.563) between 29-32 and 33-36 weeks in neonatal survival and Apgar score at 5 minutes.

Conclusions: The study suggests prevalence of PPROM of 1.3% in our setting. The most common risk factor was multigravidity. Neonatal survival did not show any difference in gestation from 29 to 36 weeks.

Keywords: preterm, rupture, membranes, neonatal, outcome.