Premature Rupture of Membranes Characteristics, Determinants, and Outcomes of in Benghazi, Libya
Affiliation(s)
Department of Obstetrics & Gynaecology, Benghazi Medical University, Benghazi, Libya.
Department of Obstetrics & Gynaecology, Benghazi Medical University, Benghazi, Libya.
ABSTRACT
Premature rupture of membranes (PROM) is a frequent phenomenon that occurs in about 4% - 7%. However, the associated sequent problems are proportionally high. Almost two thirds of PROM are spontaneous, common risk factor young mother, multiple pregnancy, genital tract infection, previous preterm delivery. The complications range from induction of labour, caesarean section, fetal pulmonary morbidity and even mortality. Objectives of the Study: To identify and quantify the risk factors and complications of premature rupture of membrane in pregnant women in Benghazi, Libya, 2012. Material and Methods: 100 pregnant women diagnosed as PROM were examined for the physical signs. Detailed gynaecological and obstetric history was reported. Laboratory investigations included cervical swabs and posterior fornix swabs under aseptic conditions Drugs including types of antibiotics, Dexamethasone and tocolytics were also included. Results: The mean age of 100 patients was 28.9 years. Most of them, 66.1% of patients received antibiotis mostly Erythromycin. Dexamethasone was given for 32.1%. FTND accounted for 62% and PTND for 10% and Caesarean section was performed for 28%. The main indications for C/S were failed induction, in 50%, 11.8% were equally distributed between; macrosomia, previous scars, drained liquor, previous C/S, breech presentation. Only 1% of new born babies had complication. Conclusions and Recommendations: Further large studies should be done for more elaboration and analytical studies to quantify the strength of each risk factor. Strategy for management of PROM should be adopted for proper timing of induction, emergency caesarean intervention with ultimate goals of minimizing and or preventing maternal and fetal complications of disease.
Premature rupture of membranes (PROM) is a frequent phenomenon that occurs in about 4% - 7%. However, the associated sequent problems are proportionally high. Almost two thirds of PROM are spontaneous, common risk factor young mother, multiple pregnancy, genital tract infection, previous preterm delivery. The complications range from induction of labour, caesarean section, fetal pulmonary morbidity and even mortality. Objectives of the Study: To identify and quantify the risk factors and complications of premature rupture of membrane in pregnant women in Benghazi, Libya, 2012. Material and Methods: 100 pregnant women diagnosed as PROM were examined for the physical signs. Detailed gynaecological and obstetric history was reported. Laboratory investigations included cervical swabs and posterior fornix swabs under aseptic conditions Drugs including types of antibiotics, Dexamethasone and tocolytics were also included. Results: The mean age of 100 patients was 28.9 years. Most of them, 66.1% of patients received antibiotis mostly Erythromycin. Dexamethasone was given for 32.1%. FTND accounted for 62% and PTND for 10% and Caesarean section was performed for 28%. The main indications for C/S were failed induction, in 50%, 11.8% were equally distributed between; macrosomia, previous scars, drained liquor, previous C/S, breech presentation. Only 1% of new born babies had complication. Conclusions and Recommendations: Further large studies should be done for more elaboration and analytical studies to quantify the strength of each risk factor. Strategy for management of PROM should be adopted for proper timing of induction, emergency caesarean intervention with ultimate goals of minimizing and or preventing maternal and fetal complications of disease.
Cite this paper
Gahwagi, M. , Busarira, M. and Atia, M. (2015) Premature Rupture of Membranes Characteristics, Determinants, and Outcomes of in Benghazi, Libya. Open Journal of Obstetrics and Gynecology, 5, 494-504. doi: 10.4236/ojog.2015.59072.
Gahwagi, M. , Busarira, M. and Atia, M. (2015) Premature Rupture of Membranes Characteristics, Determinants, and Outcomes of in Benghazi, Libya. Open Journal of Obstetrics and Gynecology, 5, 494-504. doi: 10.4236/ojog.2015.59072.
References
[1] Mercer, B.M., Goldenberg, R.L., Meis, P.J., et al. (2000) The Preterm Prediction Study: Prediction of Preterm Premature Rupture of the Membranes Using Clinical Findings and Ancillary Testing. American Journal of Obstetrics & Gynecology, 183, 738-745. [2] Mercer, B.M., Moretti, M.L., Prevost, R.R., et al. (1992) Erythromycin Therapy in Preterm Premature Rupture of the Membranes: A Prospective, Randomized Trial of 220 Patients. American Journal of Obstetrics & Gynecology, 166, 794-802.
http://dx.doi.org/10.1016/0002-9378(92)91336-9 [3] Johnson, J.W.C., Egerman, R.S. and Moorhead, J. (1990) Cases with Ruptured Membranes That “Reseal”. American Journal of Obstetrics & Gynecology, 163, 1024-1030.
http://dx.doi.org/10.1016/0002-9378(90)91117-U [4] Silver, R.K., MacGregor, S.N. and Hobart, E.D. (1989) Impact of Residual Amniotic Fluid Volume in Patients Receiving Parenteral Tocolysis after Premature Rupture of the Membranes. American Journal of Obstetrics & Gynecology, 161, 784-787.
http://dx.doi.org/10.1016/0002-9378(89)90402-X [5] VIntzileos, A.M., Campbell, W.A., Nochimson, D.J., et al. (1986) Qualitative Amniotic Fluid Volume versus Amniocentesis in Predicting Infection in Preterm Premature Rupture of the Membranes. Obstetrics & Gynecology, 67, 579-583. [6] Mercer, B.M. (2003) Premature Rupture of the Membranes. An Expert’s View. Obstetrics & Gynecology, 101, 178-193.
http://dx.doi.org/10.1016/S0029-7844(02)02366-9 [7] Lonky, N.M. and Hayashi, R.H. (1988) A Proposed Mechanism for Pre Mature Rupture of the Membranes. Obstetrical & Gynecological Survey, 43, 22-28.
http://dx.doi.org/10.1097/00006254-198801000-00003 [8] Omero, R., Yoon, B.H., Mazor, M., et al. (1993) A Comparative Study of the Diagnostic Performance of Amniotic Fluid Glucose, White Blood Cell Count, IL 6, and Gram Stain in the Detection of Microbial Invasion in Patients with Preterm Premature Rupture of Membranes. American Journal of Obstetrics & Gynecology, 169, 839-851.
http://dx.doi.org/10.1016/0002-9378(93)90014-A [9] Vintzileos, A.M., Bors Koefoed, R., Pelegano, I.F., et al. (1987) The Use of Fetal Biophysical Profile Improves Pregnancy Outcome in Premature Rupture of the Membranes. American Journal of Obstetrics & Gynecology, 157, 236-240.
http://dx.doi.org/10.1016/S0002-9378(87)80141-2 [10] Al-Hussini, T.K., Mohamed, S.N., Alam Eldin, H. and Ahmed, A. (2012) Cervicovaginal Infection during Pregnancy and Its Relation to Preterm pre Labour Rupture of Membranes. The Journal of American Science, l8, 364-373. [11] Noor, S., Fawwad, A., Shahzd, H., Sultanna, R. and Bashir, R. (2010) Foetomaternal Outcome in Patients with or without Premature Rupture of Membranes. Journal of Ayub Medical College, Abbottabad: JAMC, 22, 164-167. [12] Smith, G., Rafuse, C., Anand, N., Brennan, B., Connors, G., Crane, J., et al. (2005) Prevalence, Management and Outcomes of Preterm Prelabour Rupture of the Membranes of Women in Canada. Journal of Obstetrics and Gynaecology Canada, 27, 547-553. [13] Tahir, S., Aleem, A. and Aziz, R. (2001) Incidence and Outcome of Premature Preterm Rupture of Membranes. Pakistan Journal of Medical Sciences, 18, 26-32. [14] Modena, A.B., Kaihura, C. and Fieni, S. (2004) Prelabour Rupture of the Membranes: Recent Evidence. Acta Biomedica, 75, 5-10. [15] Asindi, A., Archibong, E.I. and Mannan, A.B. (1999) Neonatal Septicaemia. Saudi Medical Journal, 20, 924-948. [16] Mercer, B.M. (2003) Preterm Premature Rupture of the Membranes: An Expert’s View. Obstetrics & Gynecology, 101, 178-193.
http://dx.doi.org/10.1016/S0029-7844(02)02366-9 [17] Karat, C., Madhivanan, P., Krupp, K., Pornima, S., Jayanthi, N.V., Suguna, J.S. and Mathai, E. (2002) The Clinical and Microbiological Correlates of Premature Rupture of Membranes. Indian Journal of Medical Microbiology, 24, 283-285.
http://dx.doi.org/10.4103/0255-0857.29388 [18] Harding, J.E., Pang, J., Knight, D.B. and Liggins, G.C. (2001) Do Antenatal Corticosteroids Help in the Setting of Preterm Ruprure of Membranes? American Journal of Obstetrics & Gynecology, 184, 131-139. [19] Mitchell, T.F., Pearlman, M.D., Chapman, R.L., et al. (2001) Maternal and Transplacental Pharmacokinetics of Cefazolin. Obstetrics & Gynecology, 98, 1075-1079.
http://dx.doi.org/10.1016/s0029-7844(01)01629-5 [20] Elsalmani, L. and Asadi, M. (2002) The Caesarean Section Rate in Cases with Premature Rupture of Membranes (PROM) at 36th Week of Pregnancy. Acta Medica Iranica, 40, 83-87.
[1] Mercer, B.M., Goldenberg, R.L., Meis, P.J., et al. (2000) The Preterm Prediction Study: Prediction of Preterm Premature Rupture of the Membranes Using Clinical Findings and Ancillary Testing. American Journal of Obstetrics & Gynecology, 183, 738-745. [2] Mercer, B.M., Moretti, M.L., Prevost, R.R., et al. (1992) Erythromycin Therapy in Preterm Premature Rupture of the Membranes: A Prospective, Randomized Trial of 220 Patients. American Journal of Obstetrics & Gynecology, 166, 794-802.
http://dx.doi.org/10.1016/0002-9378(92)91336-9 [3] Johnson, J.W.C., Egerman, R.S. and Moorhead, J. (1990) Cases with Ruptured Membranes That “Reseal”. American Journal of Obstetrics & Gynecology, 163, 1024-1030.
http://dx.doi.org/10.1016/0002-9378(90)91117-U [4] Silver, R.K., MacGregor, S.N. and Hobart, E.D. (1989) Impact of Residual Amniotic Fluid Volume in Patients Receiving Parenteral Tocolysis after Premature Rupture of the Membranes. American Journal of Obstetrics & Gynecology, 161, 784-787.
http://dx.doi.org/10.1016/0002-9378(89)90402-X [5] VIntzileos, A.M., Campbell, W.A., Nochimson, D.J., et al. (1986) Qualitative Amniotic Fluid Volume versus Amniocentesis in Predicting Infection in Preterm Premature Rupture of the Membranes. Obstetrics & Gynecology, 67, 579-583. [6] Mercer, B.M. (2003) Premature Rupture of the Membranes. An Expert’s View. Obstetrics & Gynecology, 101, 178-193.
http://dx.doi.org/10.1016/S0029-7844(02)02366-9 [7] Lonky, N.M. and Hayashi, R.H. (1988) A Proposed Mechanism for Pre Mature Rupture of the Membranes. Obstetrical & Gynecological Survey, 43, 22-28.
http://dx.doi.org/10.1097/00006254-198801000-00003 [8] Omero, R., Yoon, B.H., Mazor, M., et al. (1993) A Comparative Study of the Diagnostic Performance of Amniotic Fluid Glucose, White Blood Cell Count, IL 6, and Gram Stain in the Detection of Microbial Invasion in Patients with Preterm Premature Rupture of Membranes. American Journal of Obstetrics & Gynecology, 169, 839-851.
http://dx.doi.org/10.1016/0002-9378(93)90014-A [9] Vintzileos, A.M., Bors Koefoed, R., Pelegano, I.F., et al. (1987) The Use of Fetal Biophysical Profile Improves Pregnancy Outcome in Premature Rupture of the Membranes. American Journal of Obstetrics & Gynecology, 157, 236-240.
http://dx.doi.org/10.1016/S0002-9378(87)80141-2 [10] Al-Hussini, T.K., Mohamed, S.N., Alam Eldin, H. and Ahmed, A. (2012) Cervicovaginal Infection during Pregnancy and Its Relation to Preterm pre Labour Rupture of Membranes. The Journal of American Science, l8, 364-373. [11] Noor, S., Fawwad, A., Shahzd, H., Sultanna, R. and Bashir, R. (2010) Foetomaternal Outcome in Patients with or without Premature Rupture of Membranes. Journal of Ayub Medical College, Abbottabad: JAMC, 22, 164-167. [12] Smith, G., Rafuse, C., Anand, N., Brennan, B., Connors, G., Crane, J., et al. (2005) Prevalence, Management and Outcomes of Preterm Prelabour Rupture of the Membranes of Women in Canada. Journal of Obstetrics and Gynaecology Canada, 27, 547-553. [13] Tahir, S., Aleem, A. and Aziz, R. (2001) Incidence and Outcome of Premature Preterm Rupture of Membranes. Pakistan Journal of Medical Sciences, 18, 26-32. [14] Modena, A.B., Kaihura, C. and Fieni, S. (2004) Prelabour Rupture of the Membranes: Recent Evidence. Acta Biomedica, 75, 5-10. [15] Asindi, A., Archibong, E.I. and Mannan, A.B. (1999) Neonatal Septicaemia. Saudi Medical Journal, 20, 924-948. [16] Mercer, B.M. (2003) Preterm Premature Rupture of the Membranes: An Expert’s View. Obstetrics & Gynecology, 101, 178-193.
http://dx.doi.org/10.1016/S0029-7844(02)02366-9 [17] Karat, C., Madhivanan, P., Krupp, K., Pornima, S., Jayanthi, N.V., Suguna, J.S. and Mathai, E. (2002) The Clinical and Microbiological Correlates of Premature Rupture of Membranes. Indian Journal of Medical Microbiology, 24, 283-285.
http://dx.doi.org/10.4103/0255-0857.29388 [18] Harding, J.E., Pang, J., Knight, D.B. and Liggins, G.C. (2001) Do Antenatal Corticosteroids Help in the Setting of Preterm Ruprure of Membranes? American Journal of Obstetrics & Gynecology, 184, 131-139. [19] Mitchell, T.F., Pearlman, M.D., Chapman, R.L., et al. (2001) Maternal and Transplacental Pharmacokinetics of Cefazolin. Obstetrics & Gynecology, 98, 1075-1079.
http://dx.doi.org/10.1016/s0029-7844(01)01629-5 [20] Elsalmani, L. and Asadi, M. (2002) The Caesarean Section Rate in Cases with Premature Rupture of Membranes (PROM) at 36th Week of Pregnancy. Acta Medica Iranica, 40, 83-87.