Multiple vaginal examinations and early neonatal sepsis

Abstract

Background: Early onset neonatal sepsis (EONS) is caused mainly by organisms present in the genital tract. Maternal risk factors increase the incidence of EONS. This study was done to find out the association between one such risk factor i.e., multiple vaginal examinations and EONS. Methods: Case control study. 114 patients with three or more vaginal examinations after rupture of membranes were taken as cases and 114 patients with less than three vaginal examinations after rupture of membranes were taken as controls. All these babies were followed up for the development of EONS. Results: Of the 114 cases, 6 babies developed EONS. None of the babies in the control group developed EONS. So, 3 or more vaginal examinations after rupture of membranes in labour is significantly associated with early onset neonatal sepsis with p-value of 0.01305. Conclusions: Multiple vaginal examinations after rupture of membranes is a risk factor for early onset neonatal sepsis.

Maternal factors associated with early-onset neonatal sepsis among term babies delivered by caesarean section: a case-control study at Mbarara Regional Referral Hospital, Uganda

“…Babies born to mothers who had multiple (> 3) vaginal examinations after rupture of membranes had higher odds of developing EONS compared to those who had three or less. Similar ndings were observed in previous studies [33][34][35]. This is because EONS is primarily caused by ascending organisms from the maternal genital tract.…”

Effect of Maternal Colonization with History of Prolonged Rupture of Membrane on Neonatal Colonization and Early Onset Sepsis

“…Another study conducted by Effat et al 18 showed 76.9% new born were positive for both CRP and blood C/S. In our study 49.4% new born of mothers with PROM and more than 2 digital per vaginal examinations before delivery were positive for blood C/S in contrast study done by Usha et al 19 it was 1.7% only.…”

Evaluation of Epidural Analgesia Use During Labor and Infection in Full-term Neonates Delivered Vaginally

“…Third, we could not obtain the exact numbers of vaginal examinations in the participants, which is associated with neonatal infection. 41 However, the numbers of vaginal examinations were associated with labor duration because it was performed every 2 hours during the labor according to the hospital policy, and longer labor duration was associated with epidural analgesia in our study. Moreover, although the use of oxytocin and instrument delivery was more common in the epidural analgesia group than the no epidural analgesia group, the exact associations of vaginal examination, use of oxytocin, and instrument delivery with neonatal infection were not investigated in this present study.…”

“…However, the findings from this study are still clinically useful when obstetricians counsel a parturient woman regarding epidural analgesia because most parturient women have scheduled vaginal delivery rather than cesarean delivery. Third, we could not obtain the exact numbers of vaginal examinations in the participants, which is associated with neonatal infection . However, the numbers of vaginal examinations were associated with labor duration because it was performed every 2 hours during the labor according to the hospital policy, and longer labor duration was associated with epidural analgesia in our study.…”