Rupture Prematuree Des Membranes Sur Grossesse A Terme : Prise En Charge, Au Centre Hospitalier Universitaire De Brazzaville
Objective: To describe the management of pregnant woman with premature rupture of membranes at term. Patients and methods: A Cross sectional study conducted during two months. Were included, pregnant women with a gestational age greater than or equal to 37 weeks who presented a Premature Rupture of Membranes (PROM). Those with associated fetal death in utero, were excluded. Results: The frequency of PROM was 4.25% of deliveries; the pregnant mean age was 29.5 years, ranging from 16 to 46 years. Thirty-seven pregnant or 80.4% have performed more than 4 prenatal consultations. Etiological research was unsuccessful in 42 cases (91.3%) At admission, we observed 13 pregnant (28.3%) not in labor. 23 pregnant in labor transition stage. Sixteen pregnant women (34.8%) had meconium. The duration PROM was 1 to 6 hours, with over a third of pregnant women. The Caesarean delivery was the mode of delivery the most common with 27 cases (58.7%). Thirty-two infants (69.6%) born from mothers who experienced rupture of membranes had a rating Apgar in the first minute of 7 to 10; this score was between 4 and 6 in 14 newborns (30.4%). When the Apgar was between 4 and 6 in the first minute, the Fisher test indicates no significant difference between mode of delivery and the color of the amniotic fluid. By cons when the Apgar was between 7 and 10, the difference was significant, and there are 68.2% of vaginal deliveries when the amniotic fluid is clear. For the Apgar score between 7 and10, 100% of vaginal deliveries. Conclusion: In case of PROM in term pregnancy with a favorable Bishop score, we practice a systematic labor induction. If local conditions are unfavorable, a wait of 24 hours is allowed, after which cervix maturation for a labor induction is performed.
