Background: Preterm birth is a global public health threat for maternal and child health. Each year, 15 million neonates are born preterm worldwide, with 40% resulting from intrauterine infections. Materials and Methods: This cross-sectional and case–control study was conducted from October to February 2019 at Ruhengeri Referral Hospital. A total of 120 swab samples were collected from 40 women, of which 20 were full-term delivery, while the other 20 were preterm delivery. The three samples, including the placental membranes, amniotic fluids, and fetal membranes, were collected immediately after birth. A sterile cotton swab was used to collect the samples and put into swab Stuart sterile plastic container to avoid sample contamination. Samples were transported in a tightly covered carrier to the clinical microbiology laboratory at INES Ruhengeri for microbiological investigation. Gram staining, culture, and biochemical tests were performed. The independent t-test was used to test for significant differences between the means of the two groups, while the Chi-square test (χ2) was used to test for significant association with microorganisms and intra-amniotic infections. Results: A half of the participants were in the age range of 24–29 years. Non-albicans candida (32.7%) and mold (27.9%) were the predominant microorganisms isolated. Non-albicans candida and mold were common to preterm and full-term samples. Staphylococcus species were observed in placental and fetal membrane samples. Escherichia coli, Klebsiella species, Streptococcus species, and Candida albicans were observed among women with preterm birth samples. There was a statistically significant difference between the two means in the amniotic fluid isolates (t = 4.023, P < 0.007), placental membrane isolates (t = 7.17, P < 0.0004), and fetal membrane isolates (t = 6.7, P < 0.0006). Association with microorganisms and intra-amniotic infection was statistically significant with E. coli (χ2 = 3.98, P < 0.05), Streptococcus species (χ2 = 5.53, P < 0.019), non-albicans candida (χ2 = 8.37, P < 0.004), and C. albicans (χ2 = 3.98, P < 0.05). Conclusions: Invasion of the amniotic fluid, placenta, and fetal membranes by pathogenic microorganisms may be associated with the incidence of preterm labor and birth. Early diagnosis is recommended to avoid both maternal and fetal complications.
Background Preterm birth could be a worldwide open well-being danger. It was assessed that each year 15 million neonates are born prematurely around the world, and 40% brought about from intrauterine infections. Methods A total of 40 women were selected. Of the 40 women, 20 had a premature birth, and the remaining 20 had a full-term birth. 120 Swab samples were collected from the placenta, amniotic fluids, and fetal membrane immediately after birth. The sterile cotton swab was used to collect samples and put into swabs Stuart plastic to avoid sample contamination. Samples were transported to the clinical microbiology laboratory at INES Ruhengeri for microbiological investigation. Gram staining, culture, and biochemical tests were performed. The independent t-test was used to test for significant difference between means of the two groups, while the chi-square test (x2) was used to test for significant association with microorganisms and intraamniotic infections. Results The findings revealed that half of the participants were in the age range of 24–29 years. Non- Albicans Candida (32.7%) and mold (27.9%) were the foremost overwhelming confined microorganisms. Some microorganisms were common to the placenta, amniotic fluid, and fetal membrane. Only Non-Albicans Candida and mold were common to samples of both preterm and full-term women, Staphylococcus species was observed in placental and fetal membrane samples and absented in amniotic fluid. Escherichia coli, Klebsiella species, Streptococcus species, and Candida Albicans were only observed among women with preterm birth. To compare isolated microorganisms between both preterm and full-term birth, the significance test of mean was performed. There was a statistically significant difference between the two means in the amniotic fluid isolates (t = 4.023, P = 0.006522), placental membrane isolates (t = 7.17, P = 0.000372), and fetal membrane isolates (t = 6.7, P = 0.000537). Association with microorganisms and intraamniotic infection was statistically significant with Escherichia coli (x2 = 3.98, P = 0.046044), Streptococcus species (x2 = 5.53, P = 0.018693), Yeast (x2 = 8.37, P = 0.003815) and Candida Albicans (x2 = 3.98, P = 0.046044). Conclusion Invasion of the amniotic fluid, placenta, and fetal membranes by pathogenic microorganisms may be associated with the incidence of preterm labor and birth. Early diagnosis is recommended to avoid both maternal and fetal complications.
Background: Chorioamnionitis is the association of microorganisms infection in fetal membrane, placental membrane and amniotic fluid. About 2 to 4% of chorioamnionitis occurs in full-term deliveries, but higher than this prevalence in preterm birth. Objectives: The objective of this study was to detect the most dominant bacteria of chorioamnionitis and evaluate correlation of the presence of microorganisms infection in placental membrane, fetal membrane and amniotic fluids in women with preterm birth. Methods: It was cross section study where 20 women with preterm premature rupture of membrane, premature rupture of membrane or preterm birth. By caesarean section or without caesarean section with a group of control of 10 women with term delivery. After delivery immediately the samples swab of amniotic fluid, fetal membrane and placenta membrane sample were placed in separate sterile container (swabs Stuart plastic) in the hospital, where it was stored at temperatures ranging between 8 o C-20 o C. Culture technique, gram staining and biochemical test were used to identify the microorganisms in this study at INES-Ruhengeri Microbiology laboratory. At the Ruhengeri Referral Hospital and analyzed according to INES Microbiology Laboratory standard operating procedures. Results: in 20 women with preterm birth, the most dominant mircoroganism was yeast 28.4% and mould 28.4%, other infections were caused by Escherichia coli, with 9.3%, Klebsiella species with 3.7%, Streptococcus species with 9.3%, Staphylococcus species with 9.3%, Candida albican with 11.7%. Those microorganisms show the association in fetal membrane, placenta membrane and amniotic fluid, of all women suspected to have chorioamnionitis. In 10 samples of control group, for women with term birth, same microorganisms were found like in fetal membrane were (Staphylococcus species 11%, mould 33%, and Yeast 56%), in placenta membrane were (Staphylococcus species 20%, mould 30%, Yeast 50%) and Amniotic fluid were (Staphylococcus species 0%, mould 33%, Yeast 67%). Conclusion: Chorioamnionitis can be in women with preterm birth or with term birth, untreated microorganism infections will cause a big problem of chorioamnionitis in pregnant women this will conduct to preterm morbidity and mortality.
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