Premature rupture of Membrane : Maternal and neonatal approach

Aim of work: To determine bacterial causative organisms of premature rupture of membrane (PROM) and its detrimental effect on maternal and neonatal outcome.
Patients and Methods: This study included 150 pregnant females at gestational age between 28 up to39 weeks who were followed up from onset of PROM till two weeks after delivery. The study included females. High vaginal swab and amniotic fluid sample were taken for culture and sensitivity. The outcome measures were the prevalence of genital tract bacterial infection, in addition to fetal and maternal complication in swab +ve patients.
Results: The mean age was 27.7±4.69 years ranged between 19-38 years, with mean gestational age of 34.81±2.7 weeks. Ninety patients (60%) were swab +ve and 60 patients (40%) were -ve cultured results. There was a significant increase in cases with positive culture results in neonatal sepsis, prematurity and early neonatal death (END). The most common organism were G(B) Beta hemolytic streptococci in mothers with Chorioamnionitis and G(A)Beta hemolytic streptococci in puerperal sepsis. The most commonest organism founded in swab +ve cases with neonatal sepsis was Coagulase -ve Staph, while it was G(b) StreptAglactiae was in premature cases, E-coli in incubated neonates, and non-hemolytic streptococci organism in cases with END.
Conclusion: The screening of the vaginal infections in patients complain of PROM, can be a useful method for prediction of preterm labor. Bacterial role in the etiology of PROM has been suggested. The mother with PROM, also her neonate, might gain some benefit from this rapid tests and antibiotics treatment.