Background. Premature rupture of membranes (PROM) is a common condition in developed and developing countries and poses a serious threat to the maternal and fetal well-being if not properly managed. This study delineated the prevalence and predictors of PROM in the western part of Uganda so as to guide specific preventive measures. Methods. A cross-sectional study design was conducted in the months of September 2019 to November 2019. A total of 334 pregnant women above 28 weeks of gestation admitted at the maternity ward of KIU-TH were consecutively enrolled. Interviewer-administered questionnaires were used to obtain the data. Descriptive statistics followed by binary logistic regression were conducted. All data analyses were conducted using STATA 14.2. Results. Of the 334 pregnant women enrolled, the prevalence of PROM was found to be 13.8%. The significant independent predictors associated with lower odds of PROM were no history of urinary tract infection (UTI) in the month preceding enrollment into the study (aOR = 0:5, 95% CI: 0.22-0.69, p = 0:038) and gestational age of 37 weeks or more (aOR = 0:3, 95% CI: 0.14-0.71, p = 0:01) while history of 3 or more abortions (aOR = 13:1, 95% CI: 1.12-153.62, p = 0:05) was associated with higher likelihood of PROM. Conclusions. Majorly urinary tract infections, low gestational age, and abortions influence premature rupture of membranes among women. There is a great need for continuous screening and prompt treatment of pregnant women for UTI especially those with history of 3 or more abortions at less than 34 weeks of gestation.

Objective To describe stage of labor at admission among women with a prior cesarean, and examine its impact on intrapartum management and delivery mode. Methods In a prospective cohort study, women admitted to Mbarara Regional Referral Hospital, Uganda, for delivery were enrolled between March and June 2015. Rates of vaginal delivery (VBAC) and in-hospital trial of labor (TOL) were compared between early (<4 cm dilation) and late (≥4 cm) presenters. Women were interviewed after delivery about decision making and labor preferences. Results Overall, 188 women comprised the study sample; 98 (52.1%) and 65 (34.6%) women presented at ≥4 cm and ≥6 cm, respectively, and 18 (9.6%) were fully dilated. In-hospital TOL and VBAC rates were 25.5% (42/165) and 9.6% (18/188), respectively. Compared with early presenters, late presenters were significantly more likely to undergo TOL (28/88 [31.8%] vs 14/77 [18.2%]; odds ratio [OR] 2.3, 95% confidence interval [CI] 1.1–5.0), and achieve VBAC (16/98 [16.3%] vs 2/90 [2.2%]; OR 7.6, 95% CI 1.7–35.1). Conclusion Most women arrived in active labor, but most had a repeat cesarean. Work is needed to understand the clinical decision making and provider management driving low TOL and VBAC rates.

Background: Premature rupture of membranes (PROM) remains a great burden to mothers and their unborn children all over the world with several adverse maternal and fetal outcomes. This study aimed at determining common bacterial pathogens and their susceptibility patterns in women with PROM at Kampala International University Teaching Hospital (KIU-TH). Methods: This was a cross-sectional study conducted in the months of September 2019 to November 2019. A total of 334 pregnant mothers above 28 weeks of pregnancy admitted in maternity ward of KIU-TH were consecutively enrolled. Interviewer administered questionnaires and laboratory forms were used to collect data. Endocervical swabs were obtained from those with PROM and taken to the laboratory for culture and susceptibility tests. Descriptive statistics were used using STATA 14.2. Results: 46 (13.8%) mothers had PROM. Of these, the most common bacterial pathogens identified were S. aureus (29.6%), E. coli (25.9%) and N. gonorrhoeae (25.9%). Antibacterial susceptibility tests revealed highest sensitivity to imipenem (100%), nitrofurantoin (92.6%), cloxacillin (85.2%) and azithromycin (81.5%). Total resistance to amoxacillin, ceftriaxone and ampicillin was found. Conclusion: Women with PROM predominatly have Staphylococcus aureus, Escherichia coli and Neisseria gonorrhoeae. Imipenem, nitrofurantoin, cloxacillin and azithromycin are the most effective antibiotics among patients with PROM.