Preterm Prelabor Rupture of Membranes and Severe Oligohydramnios From 22-34 Weeks of Amenorrhea(Article)
She had earlier been admitted to Nsambya hospital on 30th June 2014 with the complaint of vaginal discharge for three days without other symptoms. At that time, she reported that she was asleep when she suddenly felt her bed wet. The fluid was coming from the vagina, it was clear, not blood stained, not mucoid and odorless. It was not associated with abdominal pains, fever or other genito- urinary symptoms. There was no history of trauma. The ultrasound scan done on 30th June 2014 indicated a single live fetus at 22weeks with severe oligohydramnios. The AFI was 3cm, Urinalysis was normal. She stayed in the hospital under conservative management of bed rest, pad checks and 48hourly Complete blood counts. She was later discharged at 23.6Weeks of amenorrhea on erythromycin 500mg every 6hrs for 5days and was scheduled to attend the High risk antenatal clinic. She was counselled on the danger signs and what to lookout for. She continued to have on and off mild drainage of liquor without any other symptoms for the next two months. She had three antenatal visits at hospital after discharge and serial ultra sound scans monthly which showed reduced liquor. She was given one dose of malaria prophylaxis, and hematinics. She did not continue with any oral antibiotics after stopping the erythromycin. She also abstained from sexual intercourse during the entire period. Three days prior to the re-admission, she developed progressive dull lower abdominal pain with a vaginal discharge but no bleeding. She had normal micturition habits, no fever, and no history of trauma. This is what prompted her to come to hospital otherwise she had planned to return when she is at term.
Authoured by: Daniel Zaake
Academic units: Mother Kevin Post Graduate Medical School