The Place of Transcervical Amnioinfusion in the Management of Preterm Premature Rupture of Membranes Remote from Term in a Private Institution

  • Abiodun olusanya

Abstract

Background: pPROM complicates about 10 of pregnancies and it occurs in populations of low socioeconomic status. It is a major cause of neonatal morbidity and mortality. The objective of this study was to determine the usefulness of therapeutic transcervical amnioinfusion in prolonging the latency period and thereby leading to the reduction of morbidity associated with pPROM. Methodology: This study was conducted in the department of Obstetrics and Gynaecology of Sacred Heart Hospital lantoro. In this study a total of 51 patients that met the inclusion criteria were recruited. Diagnosis of pPROM was strictly by gentle sterile speculum with evidence of either a gush of fluid from external cervical os or pool of liquor in the posterior fornix of the vagina in antenatal patients whose gestation ages were within the inclusion criteria. Statistical Package for Science Student SPSS version 21 was used in the analysis of data collected. Results: The mean age of the patients was 26.5years while the gestational age group 26-29weeks constituted 51 with the mean gestational age constituting 29.7weeks.13.7 of the patients recruited exhibited the indices of sepsis measured compared to 86.3 that did not exhibit any evidence ofm sepsis. Our study did not find any statistically significant relationship between transcervical route amnioinfusion and sepsis with the chi-square being 0.123 and the relative risk RR of 0.750 {95 CI 0.150 to 3.750}. Latency period was greatly increased in the test group compared to the control with a chi-squareX 2 of 0.000. Only one baby in the test group had asphyxia compared to 10 babies in the control arm of the study with X 2 of 0.003. There was a statistically significant relationship between 2 birth weight at birth in the test group compared to the control group with a X 2 of 0.000. There was no maternal or neonatal death in this study. Conclusion Transcervical route amnioinfusion is as safe as the transabdominal route in carefully selected patients this route is less invasive and cheaper compared to the transabdominal method and it will find usefulness in resource-constraint environments. It raises the liquor volume and prolongs latency period in patients thereby contributing to the improvement in neonatal outcome.
Published
2020-06-06