PREVALENCE, ASSOCIATED FACTORS AND PERINATAL OUTCOMES OF PREMATURE RUPTURE OF MEMBRANE AMONG PREGNANT WOMEN ADMITTED TO HIWOT FANA COMPREHENSIVE UNIVERSITY HOSPITAL, EASTERN ETHIOPIA: A RETROSPECTIVE STUDY

Abstract

Background: Premature rupture of membrane is defined as rupture of the membranes any time after 28th week of gestation and before the onset of labor.it linked to significant maternal and perinatal mortalities and morbidity. In Ethiopia, one third of preterm birth is associated with premature rupture of membrane. However, information on premature rupture of membrane, contributing factors and perinatal outcomes in the study area was limited. Objective: To assess prevalence, factors associated and perinatal outcomes of premature rupture of membrane among pregnant women admitted to Hiwot Fana Comprehensive University Hospital from May 15 to June 14/2022. Methods: A facility based cross sectional study was conducted among 424 pregnant mothers who were admitted to the hospital from January 1, 2019 to December 31, 2020. Simple random sampling was used to select records. Data were extracted from maternal medical records using a structured and pretested abstraction checklist. The data was entered using Epi-Data 3.1 and analyzed using SPSS 26. Bivariable and multivariable logistic regression analysis with 95% confidence interval were computed to identify predictors of premature rupture of membrane and described using adjusted odds ratio. All variables with p<0.25 in the binary logistic regression were entered into multivariable analysis to identify the associated factor. Statistically significant association was declared at p<0.05. Results: The prevalence of premature rupture of membrane was 16.27% (95% CI: 13.05-20.11). History of abortion [AOR=2.61; 95% CI (1.09, 6.24)], urinary tract infection [AOR=2.59; 95% CI (1.23, 5.42)], vaginal bleeding [AOR=3.35; 95% CI (1.38, 8.13)] and khat chewing in the index pregnancy [AOR=2.63; 95% CI (1.49, 4.63)] were significantly associated with premature rupture of membrane. Among the women with premature rupture of membrane 72.5% of them had adverse perinatal outcomes and 10.15% perinatal death. Conclusion: The prevalence of premature rupture of membrane in this study was relatively high. History of abortion, urinary tract infection, vaginal bleeding and khat chewing were found to be significantly associated. Prenatal risk identification, early screening, detection and treatment of identified complications and counseling is important to minimize the occurrence of premature rupture of membrane and its adverse perinatal outcome.