The clinical and microbiological correlates of premature rupture of membranes

Karat, C; Madhivanan, Purnima; Krupp, Karl; Poornima, Subhadra; Jayanthi, NV; Suguna, JS; Mathai, E

doi:10.4103/0255-0857.29388

Cited by 29 publications

(29 citation statements)

References 11 publications

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“…Karat et al reported S aureus (28%) and E coli (20%) as significant vaginal isolates in-patient with PPROM. 7 Carroll et al reported that positive genital tract cultures for aerobic and anaerobic organisms predicted 40% of positive fetal blood and 53% of positive amniotic fluid cultures. In more than 75% of cases with positive amniotic fluid cultures, the same organisms were recovered from high vaginal swabs.…”

Section: Discussionmentioning

confidence: 99%

“…To the best of our knowledge, there is only one previous study from India, which reported microbiological correlates of PPROM. 7 Antibiotic therapy in PPROM has been associated with significant reduction in incidence of chorioamnionitis, birth within one week of starting antibiotics and improved neonatal outcomes. Due to difficulty in obtaining amniotic fluid samples and various reports indicating mixed bacterial growth in amniotic fluid cultures, broad-spectrum antibiotics are prescribed during expectant management of PPROM.…”

Section: Discussionmentioning

confidence: 99%

“…However, major pathogens of neonatal infections are mostly Gram negative bacteria like Klebsiella pneumoniae, Escherichia coli, Pseudomonas sp, and Acinetobacter sp. [6][7][8] Thus, injudicious use of broad-spectrum antibiotics can lead to emergence of antibiotic-resistant organisms. 9 This study was planned to evaluate profile of genital tract organisms in Indian women with PPROM and their sensitivity to commonly used antibiotics (ampicillin, cefazolin and gentamicin).…”

Section: Introductionmentioning

confidence: 99%

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Vaginal flora in preterm premature rupture of membranes and their sensitivity to commonly used antibiotics

Rani

Mehra

Gupta³

et al. 2014

Asian J Med Sci

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Background: Ascending infection is one of the most common etiologies in preterm premature rupture of membranes (PPROM). Antibiotics are used in PPROM to prolong the pregnancy and to prevent infection. But to prevent drug overuse and resistance, microorganism directed antibiotics should be used. So, this study was planned to evaluate vaginal flora in pregnant women with PPROM and their sensitivity to commonly used antibiotics. Methods: In this prospective cross-sectional study, 50 pregnant women (cases) preterm premature rupture of membranes and 28 pregnant women (controls) without complication were assessed for the type of vaginal flora and its sensitivity to commonly used antibiotics. Results: Among cases 18 (36%) women showed bacteria on Gram's staining of vaginal swabs with Gram-negative bacteria (10/18) being the most common. Among controls, 16 (57%) women showed bacteria on Gram's staining with Gram-positive bacteria being most common. Among cases Escherichia coli and Staphylococcus aureus were the commonest isolates. Of 8 (16%) positive bacterial cultures in cases, 6 (10%) were sensitive to Gentamicin and 2 (4%) to Ampicillin. Conclusion: Lower genital tract flora of pregnant women with PPROM predominantly consists of Gram-negative bacteria, which are sensitive to Gentamicin.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Vaginal flora in preterm premature rupture of membranes and their sensitivity to commonly used antibiotics

Rani

Mehra

Gupta³

et al. 2014

Asian J Med Sci

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“…Less than 37 weeks of gestation, first trimester infection and BV were the risk factors we found to be associated with PROM [13] . These results were unlikely to be due to sample selection bias or by chance.…”

Section: Discussionmentioning

confidence: 56%

“…PROM is reportedly associated with many risk factors, including trauma and cervical tubal relaxation, a mechanical irritation occurring in late pregnancy, fetal meningitis, lower reproductive tract infections, an increase in amniotic pressure (such as in multiple pregnancies and polyhydramnios) [12][13][14] , a history of PROM in a previous pregnancy and BMI ! 20 [12] .…”

mentioning

confidence: 99%

Polymorphisms in the MTHRF, VDR, MMP-9 and IL-β Genes and the Risk of Premature Rupture of Membranes

Fang

Li²,

Diao³

et al. 2010

Gynecol Obstet Invest

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Background: Premature rupture of membranes (PROM) occurs 2.5–3 times more often in premature births than in births that are full term, is accompanied by many complications for both the mother and fetus and can cause serious adverse consequences. Little is known about the genetic susceptibility of PROM. Objective: The purpose of this study was to evaluate the association between several genotypes and PROM in a high-risk hospital-based population. Methods: The cases were 206 pregnant women who had PROM in labor, and the controls were 287 pregnant women who did not have PROM in labor. All subjects were selected between July 2006 and July 2007 from the Maternal and Child Health Hospital in Jinan City. We genotyped the following genes: the MTHFR C677T, MMP-9 C1562T, VDR C352T and IL-1β C3593T genotypes. The associations between the genotypes and risk of PROM were analyzed. Results: The CC genotype at MTHFR C677T, combined with bacterial vaginosis, was associated with a significantly increased risk of PROM (odds ratio, OR: 3.55; 95% confidence interval, CI: 1.05–12.02). Compared to those in the stratum of 40 or more weeks of gestation, those in the stratum of 37 or less weeks of gestation had an increased risk of PROM (OR: 5.11, 95% CI: 2.0–13.05 for the TT/TC genotype of MTHFR C677T; OR: 5.31, 95% CI: 1.07–26.44 for the TC/TT genotype of MMP-9 C1562T, and OR: 6.08, 95% CI: 1.39–26.60 for the TT genotype of VDR C352T). Conclusion: The results indicated that an interaction exists between genetic and environmental factors that are related to the occurrence of PROM.

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Preterm Prelabor Rupture of Membranes Linked to Vaginal Bacteriome of Pregnant Females in the Early Second Trimester: a Case-Cohort Design

Kan

et al. 2023

Reprod. Sci.

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Preterm prelabor rupture of membranes (PPROM) is a major cause of spontaneous preterm birth (sPTB), one of the greatest challenges facing obstetrics with complicated pathogenesis. This case-cohort study investigated the association between vaginal bacteriome of singleton pregnant females in the early second trimester and PPROM. The study included 35,255 and 180 pregnant females with PPROM as cases and term-birth without prelabor rupture of membranes (TWPROM) and term prelabor rupture of membranes (TPROM) pregnant females as controls, respectively. Using 16S rRNA sequencing, the vaginal microbiome traits were analyzed. Females with PPROM had higher alpha and beta diversity ( P < 0.05) than TWPROM and TPROM. The presence of L. mulieris was associated with a decreased risk of PPROM (adjusted odds ratio [aOR] = 0.35; 95% confidence interval [CI]: 0.17–0.72) compared with TWPROM. Meanwhile, the presence of Megasphaera genus (aOR = 2.27; 95% CI: 1.09–4.70), Faecalibacterium genus (aOR = 3.29; 95% CI: 1.52–7.13), Bifidobacterium genus (aOR = 3.26; 95% CI: 1.47–7.24), Xanthomonadales genus (aOR = 2.76; 95% CI: 1.27–6.01), Gammaproteobacteria class (aOR = 2.36; 95% CI: 1.09–5.14), and Alphaproteobacteria class (aOR = 2.45; 95% CI: 1.14–5.26) was associated with an increased risk of PPROM compared with TWPROM. Our results indicated that the risk of PPROM can decrease with vaginal L. mulieris but increase with high alpha or beta diversity, and several vaginal bacteria in pregnant females may be involved in the occurrence of PPROM. Supplementary Information The online version contains supplementary material available at 10.1007/s43032-022-01153-0.

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The clinical and microbiological correlates of premature rupture of membranes

Cited by 29 publications

References 11 publications

Vaginal flora in preterm premature rupture of membranes and their sensitivity to commonly used antibiotics

Vaginal flora in preterm premature rupture of membranes and their sensitivity to commonly used antibiotics

Polymorphisms in the MTHRF, VDR, MMP-9 and IL-β Genes and the Risk of Premature Rupture of Membranes

Preterm Prelabor Rupture of Membranes Linked to Vaginal Bacteriome of Pregnant Females in the Early Second Trimester: a Case-Cohort Design

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