Perinatal outcomes in pregnant women presenting with preterm premature rupture of membranes at a regional hospital in KwaZulu- Natal Province, South Africa

Abstract

Background. Worldwide, the incidence of preterm premature rupture of membranes (PPROM) is between 1% and 4% of all pregnancies.

Objectives. The primary objectives of this study were to describe and compare the perinatal outcomes of HIV-positive and HIV-negative women presenting with PPROM to a regional hospital in KwaZulu-Natal.

Methods. This was a retrospective analytical cross-sectional study which reviewed files of pregnant women presenting with premature rupture of membranes at gestation between 28 and 36 completed weeks. These were identified from the labour ward birth register and from the neonatal ward admission book. Categorical and numerical variables pertaining to the method of confirmation of diagnoses, clinical profiles, modes of delivery, maternal outcomes and neonatal outcomes were considered.

Results. A total of 87 files were analysed. Forty-six women (53%) were HIV-negative and 41 (47%) were HIV-positive. Fifty-two percent were in the gestational age <34 weeks. Fifty-nine percent (n=51) of women delivered vaginally and 31% (n=27) delivered by caesarean delivery (CD). There was also no statistical significance between the Apgar scores of the HIV-exposed and HIV-unexposed neonates, birth weights and modes of delivery. There was no statistical significance in sepsis rates, the need for ventilation and the duration of hospital stay between the two groups. The odds of developing neonatal jaundice (NNJ) in the HIV-positive group was 0.14(95% confidence interval (CI) 0 - 0.93), which was statistically significant. There was no reported maternal or neonatal mortality and no maternal morbidity associated with PPROM in either groups.

Conclusion. This study suggests that there are no immediate significant differences in neonatal and maternal outcomes in pregnancies complicated by PPROM between HIV-negative and HIV-positive women on ART except that of NNJ.