Effect of Using Prophylactic Antibiotics by Patients More than 34 Weeks with Premature Rupture of Membrane on Maternal and Neonatal Outcomes

Abstract

Background: Preterm premature rupture of membrane (PPROM) and premature rupture of membrane (PROM) are associated with various maternal and neonatal complications. Management guidelines regarding rupture of membrane before labour is still controversial.

Aim of the study: To measure the incidence of infection among patient with PROM and to compare the fetal and maternal outcomes between patients who used antibiotic and who did not use antibiotic following rupture of membrane after 34 weeks.

Methods: A prospective cohort study was conducted in Benghazi Medical center. Study population was 136 women with gestational age more than 34weeks. The participants were randomized into two groups one were used prophylactic antibiotics following premature preterm rupture of membranes and other women didn't use antibiotics. We used three type of antibiotics Erythromycin 250mg 6 hourly for ten days , rocephine 1gm /12hourly for ten days and combined rocephine and metronidazole 500mg/12h for one week. Blood sample was obtained for both mothers and her babies before and after birth and analyzed for W.B.C and C-reactive protein.

Results: The risk of occurrence of puerperal sepsis among the women with PROM, who do not receive prophylactic antibiotic is 88.1%. The relative risk (RR) of is 0.012. with 95% CI 0.002- 0.084.

Conclusion The study strongly suggests that prophylactic use of antibiotics in prelabor premature rupture of membranes occurring at 34 or more weeks of gestation reduces the risk of neonatal sepsis and probably maternal endometritis.