A 18-year-old pregnant woman at 32 weeks of gestation presented with a one day history of per vaginal watery discharge. On examination, clear fluid was observed escaping through the cervical os with coughing, consistent with preterm premature rupture of membranes. The pregnancy had otherwise been uncomplicated up to this point. A diagnosis of preterm premature rupture of membranes at 32 weeks was made.

1. A PREGNANT LADY WITH PER
VAGINAL WATERY DISCHARGE
Dr Rahana Akter
DGO student
DMCH

2. SALIENT FEATURE
Mrs. Pinky,18 years old, primi, para 0+0, housewife of
middle class family hailing from konabari, Gagipur,
was admitted in DMCH on 1st may 2014 at her 32
weeks of pregnancy with the complaint of:
Per vaginal watery discharge for 1 day.
According to her statement she was regularly
menstruating women her L.M.P. was 19/09/2013
and accordingly her E.D.D. will be on 26/06/2014.

3. She was on regular antenatal check up and duly
immunized. Her pregnancy was uneventful. But at
her 32 weeks of pregnancy, she noticed sudden
gush of per vaginal watery discharge. It was
moderate in amount, clear, nonodouous, gradually
decreased. It is not associated with abdominal pain
or fever. She gave no history of trauma or itching
valva. Considering her personal history she was a
normotensive, nondiabetic women.

4. She is married for 1 year. Couple practiced no
contraceptive.
I examined her on 02/05/2014 and found her anxious
but cooperative, mildly anaemic, oedema was
absent,pulse-80b/min ,BP-100/70 mm hg,tem 98 F,
thyroid gland not enlarged and breast shows
normal physiological changes of pregnancy. Her
cardio-respiratory system revealed no abnormality.

5. On per abdominal examination uterus was
symmetrically enlarged, linea nigra and stria
gravidarum were present.Abdomen soft and non ter
SFH was 32 cm which correspond to her
gestasional age and abdominal girth was 84 cm.
single fetus with longitudinal lie with cephalic
presentation. Liquor volume seems to be adequate
& FHR was 146b/min.

6. On gentle sterile per speculum examination clear
watery fluid was escaping out through the os while
coughing.
From history and clinical examination my provisional
diagnosis is:

7. Primi 32 weeks of pregnancy with pre term premature
rupture of membrane.