CLINICO-MICROBIOLOGICAL PROFILE AND FETO-MATERNAL OUTCOME IN PRETERM PREMATURE RUPTURE OF MEMBRANES: A 1YEAR PROSPECTIVE, TERTIARY CARE SINGLE-CENTRE STUDY.

2020 ◽  
pp. 5-7
Author(s):  
Shridevi Metgud ◽  
Ramita Malla ◽  
Sharada Metgud
Keyword(s):  
Tertiary Care ◽  
Preterm Births ◽  
Obstetric Outcome ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Tertiary Care Centre ◽  
Vaginal Infections ◽  
Preterm Premature Rupture ◽  
Single Centre Study ◽  
Nicu Admission

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 prole 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 prole 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 signicant 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.

STUDY OF MATERNALAND PERINATAL OUTCOME IN CASES OF PRETERM PREMATURE RUPTURE OF MEMBRANES

2021 ◽  
pp. 11-14
Author(s):  
Madhuri Rani ◽  
Kumudini Jha ◽  
Debarshi Jana
Keyword(s):  
Perinatal Outcome ◽  
Tertiary Care ◽  
Birth Asphyxia ◽  
Preterm Births ◽  
Perinatal Morbidity ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Tertiary Care Centre ◽  
Singleton Pregnancy ◽  
Preterm Premature Rupture

Background: Preterm premature rupture of membranes (PPROM) occurs in 3%to6% of pregnancies and is responsible for approximately one third of all preterm births. Aims & Objective: of present study was to analyse the maternal and perinatal outcome of PPROM patients between 28 to 36 weeks +6days admitted in labour room of obs and gynae dept. of DMCH from January 2019 to April 2020. Material and Methods: It is hospital based prospective observational study of 100 patients of preterm premature rupture of membranes in between 28-36 weeks+6 days gestation with singleton pregnancy admitted in our tertiary care centre (Department of Obstetrics and Gynaecology, DMCH, Laheriasarai, Bihar). Results: In this study 42% patients went into spontaneous labour and 58% needed induction or augmentation. 68% patients had vaginal delivery and 23% required LSCS. The main indications for LSCS being malpresentation (26%) followed by foetal distress (22%). There was no maternal mortality; morbidity was found in 15% patients. Perinatal morbidity was seen in 40% and was mainly due to RDS, sepsis andhyperbilirubinaemia . Perinatal mortality was seen in 17% and was due to sepsis in 29.4%, RDS in 52.94% and birth asphyxia in 17.6%. Conclusion: PPROM is one of the important causes of preterm birth that can result in high perinatal morbidity & mortality along with maternal morbidity. Looking after a premature infant puts immense burden on the family, economy and health care resources of the country. Therefore management of PPROM requires accurate diagnosis and evaluation of the risks and benets of continued pregnancy or expeditious delivery. An understanding of gestational age dependent neonatal morbidity and mortality is important in determining the potential benets of conservative management of preterm PROM at any gestation

scholarly journals Maternal and perinatal outcome in preterm premature rupture of membranes

2017 ◽  
Vol 6 (6) ◽  
pp. 2498
Author(s):  
Jameela Diraviyam M. V. ◽  
Lalithambica Karunakaran
Keyword(s):  
Perinatal Mortality ◽  
Conservative Management ◽  
Perinatal Outcome ◽  
Latency Period ◽  
Perinatal Outcomes ◽  
Preterm Births ◽  
Perinatal Complications ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture

Background: Preterm premature rupture of membranes (PPROM) occurs in 3% of pregnancies and is responsible for approximately one third of all preterm births. Objective of present study was to analyse the maternal and perinatal outcome of PPROM patients between 28 to 36 weeks +6daysMethods: A descriptive study was conducted on 141 antenatal patients between 28 to 36weeks+6days with PPROM admitted to Department of Obstetrics and Gynecology, Government TD Medical College, Alappuzha, Kerala, India from September 2014 to September 2015. After establishing the diagnosis of PPROM patients were monitored and Maternal and perinatal outcomes were studied.Results: 77% patients had late PPROM. 60% of early PPROM latency period >24 hrs and were managed conservatively till 34 weeks. 18% had chorioamnionitis and immediate termination of pregnancy. 73% of newborns in this group needed admission due to complications of prematurity like RDS (54.54%). Perinatal mortality (2.12%) was due to sepsis. 80% of late PPROM had latency period <24 hrs and only 4% had chorioamnionitis.18.5% babies in this group had hyperbilirubinemia. There was statistically significant association between latency period and perinatal complications (p=0.001). RDS was 33% in latency period <24hrs, 18% in >24hrs and sepsis was 36% in >24hrs and 10% in <24hrs.Conclusions: The most common cause of perinatal mortality in early PPROM is prematurity and its complications. Hence conservative management to prolong pregnancy is recommended under strict monitoring for evidence of chorioamnionitis. At the earliest evidence of chorioamnionitis termination irrespective of gestational age is warranted. In late PPROM, perinatal outcome is good. So, termination is advised as conservative management shall add to the fetal and maternal morbidity due to sepsis. 

scholarly journals Persistent microbial dysbiosis in preterm premature rupture of membranes from onset until delivery

PeerJ ◽  
2015 ◽  
Vol 3 ◽  
pp. e1398 ◽  
Author(s):  
Elizabeth A. Baldwin ◽  
Marina Walther-Antonio ◽  
Allison M. MacLean ◽  
Daryl M. Gohl ◽  
Kenneth B. Beckman ◽  
...  
Keyword(s):  
Antibiotic Treatment ◽  
Preterm Births ◽  
Vaginal Microbiome ◽  
Subclinical Infection ◽  
Pathogenic Species ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Microbial Response ◽  
Vaginal Swabs

Background.Preterm Premature Rupture of Membranes (PPROM) is a major leading cause of preterm births. While the cause for PPROM remains unidentified, it is anticipated to be due to subclinical infection, since a large proportion of PPROM patients display signs of chorioamnionitis. Since subclinical infections can be facilitated by dysbiosis, our goal was to characterize the vaginal microbiome and amniotic fluid discharge upon PPROM, through latency antibiotic treatment, and until delivery, to detect the presence of pathogens, microbiota alteration, and microbial response to treatment.Methods.Enrolled subjects (15) underwent routine institutional antenatal care for PPROM, including the administration of latency antibiotics. Serial vaginal swabs were obtained from diagnosis of PPROM through delivery and the sequencing of the V3–V5 region of the 16S rRNA gene was performed for all collected samples.Results.The results show that Lactobacilli species were markedly decreased when compared to vaginal swabs collected from uncomplicated pregnancy subjects with a matched gestational time.PrevotellaandPeptoniphiluswere the most prevalent taxa in PPROM subjects at presentation. The vaginal microbiome of the PPROM subjects varied substantially intra- and inter-subjects. Several taxa were found to be significantly reduced during and after the antibiotic treatment:Weeksella,Lachnospira,Achromobacter, andPediococcus. In contrast,PeptostreptococcusandTissierellaceae ph2displayed a significant increase after the antibiotic treatment. However, the relative abundance ofLactobacillus,Prevotella, andPeptoniphiluswas not substantially impacted during the hospitalization of the PPROM subjects. The deficiency ofLactobacillus, and constancy of known pathogenic species, such asPrevotellaandPeptoniphilusduring and after antibiotics, highlights the persistent dysbiosis and warrants further investigation into mitigating approaches.Discussion.PPROM is responsible for one third of all preterm births. It is thought that subclinical infection is a crucial factor in the pathophysiology of PPROM because 25–40% of patients present signs of chorioamnionitis on amniocentesis. Here we sought to directly assess the bacterial content of the vagina and leaking amniotic fluid of subjects at presentation, throughout treatment and up until delivery, in order to search for common pathogens, microbiota changes, and microbial response to latency antibiotic treatment. We have found that the vaginal microbiome of PPROM subjects is highly variable and displays significant changes to treatment. However, the unchanging deficiency ofLactobacillus, and persistence of known pathogenic species, such asPrevotellaandPeptoniphilusfrom presentation, through antibiotic treatment and up until delivery, highlights the persistent dysbiosis and warrants further investigation into mitigating approaches.

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