A study of bacteriological profile and outcome of babies born to mother with Premature rupture of membrane and its correlation with blood and gastric culture

Abstract

Background: PROM, a condition that occurs when fetal membranes are ruptured at least one hour before onset of labor. While PROM is observed in 10% of all pregnancies, 60-80% of PROM is observed in term and 20-40% in pregnancies less than 37th gestational week. PROM is the most significant reason for preterm labor. The three causes of neonatal death associated with PROM are prematurity, sepsis and pulmonary hypoplasia. Infants born with sepsis have a mortality rate four times higher than those without sepsis. Objective of the study was correlation of blood and gastric culture positive sepsis in PROM newborns. It helps to find out the incidence of PROM in our locality.Methods: This retrospective study enrolled 90 neonates born to healthy mothers with history of PROM more than 18 hours duration, admitted in SNCU/ward at a tertiary care hospital for six months duration from 1st January 2017 to 30 June 2017. Clinical profile of these Newborn with history of PROM was noted such as birth weight, gender, gestation, duration of membrane rupture, history of maternal fever. For all newborns with PROM, sepsis screen had been sent. The neonatal outcome was also recorded, and the data was collected and analyzed by using frequency and percentages.Results: Gram negative bacilli were the commonest cause of neonatal sepsis and male neonates were more prone to infection. PROM and low birth weight especially, ELBW and VLBW are the common high-risk factors for early onset sepsis. Most common organisms isolated in blood and gastric culture were Klebsiella and Staphylococcus aureus respectively.Conclusions: PROM is a high-risk obstetric condition. Active management is needed to enable delivery within 24 hours of PROM as it offers better neonatal outcome. Morbidity and mortality increase as the duration of PROM increases. This can be reduced by early diagnosis, specific treatment and strict infection control practices in neonatal units.