Prevalence, Associated Factors, Maternal and Perinatal Outcomes of Pregnancies Complicated by Preterm Premature Rupture of Membranes Between 24 - 28 Weeks Gestational Age at Military Hospital of Kamenge

Abstract

Background: Premature preterm rupture of membrane (PPROM) is a major public health concern, complicating approximately 3% of all pregnancies globally ,with 50% of these pregnancies resulting into preterm births. The magnitude, associated factors and outcomes of PPROM in Burundi have not been extensively documented. The purpose of the study: To determine the prevalence, associated factors, maternal and perinatal outcomes of pregnancies complicated by PPROM between 24- and 28-weeks gestational age at Military Hospital of Kamenge retrospectively from December 2020. Methodology: This was an analytical cross-sectional study which adopted a simple random sampling technique. The files of 340 women admitted at the Obstetric wards between 2016-2020 at Military Hospital of Kamenge between 24 and 28 weeks of gestational age were retrieved from the central registry of the hospital. A structured data abstraction tool was used to extract patient information from the files. Frequencies and percentages were used to summarize categorial descriptive data while median and interquartile range were used to summarize continuous descriptive data. The prevalence of pregnancies complicated by PPROM between 24 and 28 weeks was calculated proportion of the total sample size included in the study. Binary logistic regression was used to investigate the factors associated with PPROM. Significance was investigated at p<0.05. Results: The findings revealed that the prevalence of PPROM among women who were included in the study was 16.2%. PPROM occurred at 27weeks in 29.1% of cases while 21.8% of women had PPROM at 25 weeks , 20% at 24th and 26th week of gestation and 9.1% had PPROM at 28th week of gestation. Multivariable model showed that, women aged 30 years and above, women who did not have any ANC visit, presence of anemia in current pregnancy and presence of HDP were significantly associated with PPROM. The findings revealed that 78.2% of women who had PPROM developed adverse complications. The common complications that were identified included placentae abruptio 27.3%, chorioamnionitis 20%, umbilical cord prolapses 14.5%, intrauterine fetal demise 16.4% and sepsis 10.9%.The neonatal findings also revealed that there were 74.5% livebirths, majority of the neonates had birthweight of less than 1.5kgs, 39% had RDS while NBU admission was 81.1% and the median length of stay was 5 days in NBU. Conclusion: The prevalence of PPROM in our study was 16.2% which contrast from previous studies which found varied prevalence of PPROM. Significant association was found between PPROM , increased maternal age, anemia, HTN and nonattendance of ANC clinic. Early screening of HDP should be done in pregnancy and women should be sensitized to attend ANC clinic so those at risk can be identified and proper follow-up of the pregnancy can be done.