Background: Premature rupture of membranes is the Preterm Premature rupture of membranes (PPROM) is the rupture of amniotic membranes before the onset of labour prior to 37 weeks gestation. PPROM complicates 3.5% to 5% of pregnancies. There are several risk factors which precipitate PPROM. The commonest risk factors are vaginal infection, short cervix, urinary tract infections. Some common complications seen in Preterm PROM are delivery within one week, cord compression, respiratory distress syndrome, abruptio placenta. Since all patients with PPROM have to be screened for vaginal infections as initiating antibiotics is an important aspect in the management. This study aims to assess the bacteriology involved in PPROM in this centre. Aim & Objectives: To determine bacteria isolated from PPROM and the antibiotic sensitivity of the isolates. Materials and Methods: This is a Cross-sectional study conducted on 60 pregnant women with PPROM who got admitted in labour room of KLE Dr. Prabhakar Kore Charitable Hospital. PPROM was confirmed by nitrazine paper and sterile speculum examination. Under aseptic conditions high vaginal swabs were collected. Result: In this study 57% of the deliveries were through cesarean section. 30% of deliveries included in this study occurred within 24 hours. Bacteria isolated were Enterococcus faecalis (39%), Escherichia coli (28%), Klebsiella pneumonia (13%), Staphylococcus aureus (11%), Proteusmirabilis (6%), Pseudomonas aeruginosa (4%). Imipenem showed (94%) sensitivity to gram negative bacteria isolated and Linezolid showed sensitivity to (77.7%) of Gram-positive isolates compared to other antibiotics. Conclusion:Vaginal infection is an important risk factor for PPROM and preterm labour. Patient with risk need to be monitored closely and correct treatment need to be given to manage PPROM reducing the chances of morbidity and mortality.
Background- The global burden of premature babies is mostly contributed by preterm births. Preterm premature rupture of membranes (PPROM) account for nearly 40% of all preterm deliveries. Objective-The study was done to evaluate the clinic-bacteriological prole and the obstetric outcome in pregnancies complicated by preterm premature rupture of membranes. Material and methods-This was a prospective cohort study of cases of PPROM admitted in the teaching hospital which is a major referral tertiary care centre. A total of 64 women were enrolled. We studied the patient demographics, bacterial prole and obstetric outcome in these women. Results-Most of the cases of PPROM were seen in low risk primigravidae. Infections were the commonest cause for PPROM. Enterococcus Faecalis was the most commonly isolated organism. The mean latent period was 3-7 days. Most women delivered vaginally. Respiratory distress and low birth weight with Apgar <6 were the common indications for NICU admission. Co-relation between TLC and hs-CRP levels was not statistically signicant across different groups. Conclusion- Effective screening for cervico-vaginal infections in pregnancy and appropriate antibiotic therapy will help reduce infection related feto-maternal morbidity and mortality. Lesser gestational ages are associated with poorer outcome.
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