Comparison of the Cervical Culture Results in Preterm Labor and Premature Rupture of Membranes

Abstract

GirişPreterm eylem tüm dünyada yeni doğan ölümleri ve konjenital anomalilerle ilişkilidir (1). Perinatal mortalitenin önde gelen sebebi olmasının yanında ortaya çıkan uzun vadeli ve ağır komplikasyonlar ve artan tedavi maliyetleri, konunun önemini artırmaktadır (2). Preterm doğan bebeklerde görme ve işitme bozuklukları, kronik akciğer hastalığı, serebral palsi ve gelişme geriliği daha sık görülmektedir (1). Perinatal morbidite ve mortalite özellikle 32. haftadan önce doğan bebeklerde görülür. Prematürite ile ilişkili hastalıklar Amerika Birleşik Devletlerinde fetal neonatal ölümlerin %70'inden fazlasının nedenidir (3).Tüm gebeliklerin %12-13'ü preterm doğumla sonlanmaktadır (4). Preterm eylem ve erken membran rüptüründe sistemik veya alt genital sistem enfeksiyonu en önemli etyolojik faktörlerdendir. Nedenler arasında ileri ya da erken anne yaşı, ekonomik durum, yetersiz prenatal bakım, geçmişte preterm eylem öyküsü, sigara içme, sık üriner sistem enfeksiyonu geçirme, stres, gebelik sırasında kanama, kronik hastalık öyküsü ve preeklampsia sayılmaktadır (5-11). İdiyopatik preterm doğumun, intrauterin enfeksiyonla ilişkili olduğu ve vajinal duş uygulamasının önemli bir risk faktörü olduğu düşünülmektedir (12, 13). Ayrıca ikinci trimesterde servikal uzunluğun azalması da risk faktörleri arasında sayılabilir (14).Erken membran rüptürü de preterm doğuma neden olabilir. Amniyon ve koryon zarlarıyla çevrili olan amniyon sıvısı, fetüse ısı transferi, fetal akciğer gelişimi, umbilikal kord ve fetüs hareketliliğini sağlar; fetüsü travmalardan Objective: To analyze the cervical culture results of pregnant women who present with normal pregnancy, preterm labor and premature rupture of membranes. Material and Methods:This study was prospectively done on 439 patients who were admitted to our hospital between January and November 2010. One hundred twenty-one were normal term pregnancies, 170 were preterm labor and 148 of them had premature rupture of membranes. The age range of the patients was 24-32 age, they were non-smokers and the mean body mass index is between 20 and 27. There was not additional disease in these patients in pre-pregnancy or pregnancy. p<0.05 was considered statistically significant.Results: Detected colonization in culture was 14.9%, 41.8%, 30.4 for normal pregnancy, preterm labor and premature rupture of membranes respectively. The most common microorganism was Escherichia coli for all groups. Colonization of microorganisms in preterm labor was statistically significant compared with normal pregnancy (p<0.001, odds ratio (OR) 4.1; 95% confidence interval (CI) 2.284-7.375). Colonization of microorganisms was also statistically significant for pregnant women with premature rupture of the membranes (p=0.003, OR 2.5; 95% CI 1.357-4.606). Conclusion:Colonization in cervical culture for preterm labor and premature rupture of membranes was statistically higher compared with normal pregnancy.Key words: Culture, preterm labor, premature rupture of membrane Amaç: Normal gebeler ile preterm eylem ve prematür membr...

The effect of genital hygiene behaviors and vaginal douching of pregnant women on preterm labor

“…38 In a study conducted in Turkey, it was found that the colonization of microorganisms is four times higher in women with PTB than in pregnant women without PTB, indicating a relationship between colonization and PTB. 21 Our research findings are similar to the findings of the literature in this respect. 12,21,38 It has been stated that VD performed for genital hygiene causes PTB.…”

“…21 Our research findings are similar to the findings of the literature in this respect. 12,21,38 It has been stated that VD performed for genital hygiene causes PTB. It has been reported that 50.2%-68.4% of women in Turkey perform VD.…”

“…In one study, genital infections were found to increase the risk of PTB by approximately five‐fold 38 . In a study conducted in Turkey, it was found that the colonization of microorganisms is four times higher in women with PTB than in pregnant women without PTB, indicating a relationship between colonization and PTB 21 . Our research findings are similar to the findings of the literature in this respect 12,21,38 …”

“…Although the rate of PTB in our study was quite high compared with the 11% worldwide prevalence, 3 it was quite close to the result (38.7%) of a study conducted in a training and research hospital in the capital city (Ankara) of Turkey. 21 Various factors may have led to this result, including the fact that a large number of pregnant women with PTL in our study population had not given birth yet and the higher likelihood of having a relatively higher-risk population (ours is a tertiary center which increases the proportion of at-risk patients).…”

“…As the number of pregnant women who came to the hospital for NST between the 20th and 37th weeks of pregnancy could not be determined through the automated system of the hospital where the study was conducted, the sample of the study was calculated according to the sample size formula for unknown population size 20 . According to this formula, at a 95% confidence interval, 1.96 degrees of freedom, and 38.7% prevalence (p), 21 the minimum number of pregnant women to be sampled was calculated as 365.…”