Natural History of Preterm Pre-labour Rupture of Membranes in a Singleton Primipara in a Rural Low-Resource Setting in the Absence of Early Antibiotic Intervention: a Case Report.

Abstract

This case report presents the clinical course of a 33-year-old primiparous woman whom at 30 weeks of gestation experienced preterm pre-labour rupture of membranes (PPROM) in a low-resource setting. The patient, with a history of primary infertility, was managed conservatively without antibiotics for 28 days at a resource-limited health facility, where she was treated until clinical symptoms indicating chorioamnionitis appeared, leading to her referral. She underwent an emergency caesarean section at 34 weeks gestational age due to suspected chorioamnionitis resulting in the delivery of a healthy male infant. However, the baby developed neonatal jaundice which was successfully managed with phototherapy over five days. This case provides insight into the natural course of PPROM that lasted for 28 days, a condition that would have been ethically challenging to study in a research setting. It emphasizes the difficulties of managing PPROM in low-resource environments, especially when there is no immediate access to antibiotics and advanced neonatal care.