Outcomes of Pre-Term Premature Rupture of Fetal Membranes at Komfo Anokye Teaching Hospital, Kumasi, Ghana

Context: Pre-term premature rupture of fetal membranes (pPROM) contributes to maternal and fetal morbidity and mortality. These include chorioamnionitis, prematurity and still-births. Various microbial organisms have been implicated. Few studies have been done on pPROM in this environment.Objectives: To determine pregnancy outcomes and microbial organisms in cultures from the endocervix, high vagina and urine of patients with pPROM.Design: Cross-sectional descriptive survey.Setting: Komfo Anokye Teaching Hospital (KATH), Ghana.Subjects: Patients admitted to KATH with fluid loss per vaginam during 1<sup>st</sup> Apil, 2005 to 30<sup>th</sup> September,2005.Methods: Structured pre-tested questionnaires were administered to patients who presented with fluid loss per vaginam followed by physical examination. Microbiology cultures were obtained from patients with proven pPROM between gestational ages 28 to 37 completed weeks. The data wasanalysed using Epi Info software.Main Outcome Measures: Maternal morbidity and mortality; delivery outcomes; microbial organisms from cultures and drug sensitivities.Results: Total antenatal admission was 1459 and eighty-five patients (5.8%) satisfied the study criteria. There was no maternal mortality but four patients (4.7%) developed chorioamnionitis.There were sixtyfour(75%) live births, nineteen (22%) stillbirths and liquor loss stopped in two (3%) resulting in normal term deliveries. The commonest organisms from the cultures were high vagina, Candida spp. (29%); endocervix, Candida spp. (23%); and urine, E. coli (19%). All bacterial isolates were sensitive tonorfloxaxinConclusions: Pregnancy outcomes in pPROM at KATH are unsatisfactory. Further controlled studies on pPROM are advocated and use of norfloxacin in pregnancy needs reconsideration.Keywords: Fetal membranes, microbial organisms