Clinical course of preterm prelabor rupture of membranes in the era of prophylactic antibiotics

Abstract

Background: Preterm prelabor rupture of membrane (PPROM) causes maternal and neonatal complications. Prophylactic antiobiotics were used in the management of PPROM. The objectives of this retrospective study were to compare clinical course and outcome of PPROM managed expectantly with prophylactic antibiotics and antenatal corticosteroids with those without prophylactic antibiotics and antenatal corticosteroids. Results: A total of 170 cases of singleton pregnant women with gestational age between 28-34weeks suffering from PROM during January 1998 to December 2009 were included; 119 cases received prophylactic antibiotics and antenatal corticosteroids while 51 cases did not received prophylactic antibiotics and antenatal corticosteroids. Median latency period in the study group was significantly longer than in the control group (89.8 vs. 24.3hours, P<0.001). The percentage of patients who did not deliver within 48hours and within 7days in the study group were also significantly higher than in control group (64.7 vs. 31.4%, P<0.001 and 29.4 vs. 7.8%, P=0.002, respectively). Maternal infectious morbidity was comparable between groups (17.6% vs. 13.7%, P=0.52). Neonatal infectious morbidity was significantly lesser in study group than control group (21% vs. 35.3%, p=0.04). Conclusions: Latency period of PPROM after using prophylactic antibiotics and antenatal corticosteroids increased while neonatal infectious morbidity was low. But maternal infectious morbidity was not increased. This retrospective study confirms the benefit of prophylactic antibiotics and antenatal corticosteroids in management of PPROM. © 2012 Phupong and Kulmala; licensee BioMed Central Ltd.