Why does premature rupture of membranes happen

Analysis of cost endured by PROM in Mexico showed a total cost for maternity and baby stay of , dollars and ,3 In addition to other costs, the total cost was 1,, In USA hospital 16, dollars was incurred [ 4 , 5 ].

Premature rupture of membranes results in maternal, infant and neonatal risks. Fetal complications after membrane rupture include infection and fetal distress due to umbilical cord compression or placental abruption. Because of these factors, women with PROM have a higher risk of cesarean delivery for non-reassuring fetal heart rate.

Necrotizing enterocolitis, and intraventricular hemorrhage are also common. Serious perinatal morbidity can lead to long-term consequences such as chronic lung disease, visual or hearing difficulties, intellectual disabilities, developmental and motor delay, cerebral palsy, or death. Pulmonary hypoplasia is a serious fetal complication which occurs following PROM. Intraamnioutic infection was found in Regarding perinatal outcome, So far neonatal and maternal mortality in the nation has declined from 49 per and per , in GC to 28 and in GC respectively.

Despite the achievements, neonatal and maternal mortality is still among the highest in the globe. PROM is one of the major causes of prematurity and infection, which in turn are the leading cause of neonatal death. Consequences of PROM; preterm labour, Low birth weight and neonatal infection are common and significant health problem in Ethiopia [ 1 , 7 , 8 ].

Other Strategies were also developed to address the problem including referring women with pre-term prolonged rupture of membranes longer than 12 h to a referral-level facility for assessment and Use of prophylactic antibiotics and steroid following pre-labour rupture of membranes [ 9 ].

Prediction and prevention of PROM would offer the best opportunity to prevent its complications. The risk factors of PROM include prior preterm birth, cigarette smoking, polyhydramnios, urinary and sexually transmitted infection, prior PROM, work during pregnancy, low Body Mass Index, bleeding, low socioeconomic status [ 3 ]. Previous studies to identify the risk factors of PROM were done at different country and different time.

Hence, this study was conducted to fill this gap by identifying the risk factors. Mekelle is the capital city of Tigray Region. There are three public hospitals and eight health centers along with many private health institutions [ 10 ]. Hospital based unmatched case control study design was implemented. The Study population was pregnant mothers who came to labour ward at public hospitals in mekelle city during the data collection period.

In Ethiopia, Rupture of membrane before 28 weeks gestation is regarded as abortion. There are three public hospitals in Mekele city. The sample size was allocated to the study hospitals proportionally based on a case flow in the preceding three months. Women with premature rupture of membranes who met the inclusion criteria were recruited consequently until the calculated sample size was attained. Women without premature rupture of membranes who met the inclusion criteria and admitted following the cases was selected using simple random sampling technique as controls and interviewed in the study period.

A Structured questionnaire and checklist developed by the Authors after reviewing different literatures was used. Data was collected by three midwifes. The questionnaire was prepared in English, and translated to Tigrigna, and back to English to ensure consistency. The Data collection was supervised. The collected data was checked for completeness, consistency and clarity.

Data was entered using EpiData version 3. Frequency and percentage was used for categorical variable. Median and inter quartile range was computed. Bivariate logistic regression model was performed to determine the crude association of the independent variables with the dependent variable.

Efforts were made to confirm the fulfillment of major assumption of logistic regression. Absence of multicolinarity was found to be satisfied. Goodness of fit was checked by Hosmer and Lemeshow test and Omnibus test of model coefficients.

More than half of cases and controls were housewives, and the majority of cases and controls have attended more than secondary Education. Regarding residence, majority of cases and controls were living in urban. Majority of cases and controls belong to Tigray ethnicity. Proportion of partner job, as a daily laborer is higher in cases than controls Table 1. The majority of the participants have no history of carrying heavy objects.

Regarding to sleep more than two third of cases and controls reported that they sleep less than 8 h per day. It was observed that low proportion of cases and controls have a maid Table 2. Twenty-five Among the women who had an abortion, almost quarter of cases and 1 out of 10 controls had two abortions. One hundred two controls and A few women in both case and control groups had cervical operation and cerclage.

More than half of pregnant women, in case group and almost two third of pregnant women in control group has used modern contraceptive; the injectable being the commonly used one. Lower proportion of women had caesarean section in both case and control groups Table 3. The median gestational age of the pregnant women was Proportions of Primigravida and Nullipara mothers were higher in the control group than cases.

A small number of cases and controls had mid-upper arm circumference below 23 cm. Abnormal vaginal discharge was reported by almost half of cases and The proportion of mothers who had antenatal care follow up in the cases, and controls was high. To learn more about Healthwise, visit Healthwise. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated. Top of the page.

Topic Overview Before a baby is born, the amniotic sac breaks open, causing amniotic fluid to gush out or, less commonly, to slowly leak. Overstretching distension of the uterus and amniotic sac. Multiple fetuses or too much amniotic fluid polyhydramnios are common causes of distension. Trauma, as from an injury. Standard treatment for pPROM Standard treatment for pPROM includes antenatal corticosteroid medicines, which are used to speed up fetal lung maturity at or before 34 weeks of pregnancy.

Antibiotics , given to treat or prevent amniotic fluid infection. Bring someone with you to help you ask questions and remember what your provider tells you.

At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you. Know why a new medicine or treatment is prescribed, and how it will help you.

Also know what the side effects are. Know what to expect if you do not take the medicine or have the test or procedure. If you have a follow-up appointment, write down the date, time, and purpose for that visit. Search Encyclopedia.

These things may increase your risk: Having a preterm birth in a previous pregnancy Having an infection in your reproductive system Vaginal bleeding during pregnancy Smoking during pregnancy What are the symptoms of PPROM? Symptoms can occur a bit differently in each pregnancy.

They can include: A sudden gush of fluid from your vagina Leaking of fluid from your vagina A feeling of wetness in your vagina or underwear Call your healthcare provider right away if you have these symptoms. Testing may include: pH acid-base balance testing.

Hospital stay and bed rest Your healthcare provider will watch you closely. Medicine You may need these medicines: Corticosteroids. Tocolytic medicines. Already a member or subscriber? Log in. Interested in AAFP membership? Learn more. Medina completed a fellowship in family practice obstetrics at Florida Hospital, Orlando. Address correspondence to D. Ashley Hill, M. Reprints are not available from the authors.

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