Prevalence and outcome of Preterm Premature Rupture of Membranes (PPROM) among pregnant women attending Ain Shams maternity hospital

Background: Preterm premature rupture of membranes (PPROM) is one of the leading
identifiable causes of premature birth and it accounts for high rates of perinatal deaths in
developed and developing countries. Objectives: The study was conducted to measure the
prevalence of PPROM among pregnant women attending Ain Shams maternity hospital,
and to identify the fetal/neonatal outcome among pregnant women presented with PPROM
and potential factors associated with poor fetal/neonatal outcome. Method: A cross
sectional study was conducted on two phases using data retrieved from computerized
hospital information system (HIS), Ain Shams Maternity Hospital. Data about all
deliveries from 2011-2015 was revised from Hospital Information System to calculate the
frequency of PPROM during these years. A sample of 300 medical files of pregnant
women who were diagnosed with PPROM before 37 weeks and admitted to the hospital in
the year 2015 were then extracted from the hospital archive and revised using a checklist
developed by the investigators. Relevant data was obtained from these medical files.
Results: Prevalence of PPROM ranged from 2.4% in 2011 to 4.7% in 2015 with the
highest rate during 2013 (5.3%). Only 4.3% of women presented with PPROM developed
chorio-amnionitis. Regarding fetal outcome, 61.3% of infants developed a poor fetal
outcome including; (fetal death and ICU admission), while 38.7% of infants had good
fetal outcome (alive & well). By multivariate analysis women employment (OR 1.9 CI 1.2
– 3.5), gush type of PPROM (OR 1.9 CI 1.4 – 3.6), history of chorioamnionitis (OR 14.5
CI 12.4 – 132.1), delivery by CS (OR 2.5 CI 2.01 – 4.5) and later gestational age at
PPROM (OR 0.8 CI 0.2 – 0.9) were significant independent predictors of poor fetal
outcome. Conclusion & Recommendations: Prevalence PPROM at Ain Shams maternity
hospital is increasing during study duration with fetal/neonatal complications that
necessitate proper antenatal care and proper management.