Nelly A., 17

Nelly lives with her parents and siblings in a two-room mud-walled house. Her parents are subsistence farmers with no regular income. A Form Three student, Nelly relies on bursaries to remain in school. At times, her parents perform tasks such as cleaning or splitting firewood at the school in exchange for her continued attendance. She dreams of becoming a doctor. After missing her periods, Nelly informed her mother, who took her to a nearby facility where pregnancy was confirmed. She enrolled for antenatal care, attended her appointments with her mother and continued schooling. At 31 weeks, she awoke to a sudden, persistent gush of fluid that worsened whenever she stood or sat upright. Her mother rushed her to hospital, where she was diagnosed with preterm premature rupture of membranes. She had a twin pregnancy and it was noted that one of the twins was also in fetal distress, making an emergency Caesarean section necessary. Worried about the cost, her mother was informed by the labour ward in-charge about Helpster Charity and the possibility of receiving assistance with the urgent treatment.

A 17-year-old patient with preterm prelabour rupture of membranes (PPROM) in a twin pregnancy, with one twin in breech presentation, is considered a high-risk obstetric case but with prompt obstetric management, close maternal and fetal monitoring, appropriate antibiotics and antenatal corticosteroids when indicated, and access to neonatal care, the outcome can be favorable.