Background: One of the most important etiologies in pretermpremature rupture of
membranes (PPROM) is cervical bacterial colonization.
Objective: This study evaluated cervical bacterial colonization in women with
PPROM and the pregnancy outcomes.
Materials and Methods: In this cohort study, 200 pregnant women with PPROM at
27-37 wk of gestation who were admitted in an academic hospital of Mashhad
University of Medical Sciences from March 2015 to July 2016 were studied.
samples were obtained from endocervical canal for detection of routine bacteria and
Gram staining. Also, we obtained one blood culture from neonates. Maternal
endocervical culture, chorioamnionitis, neonatal intensive care unit admission,
neonatal positive blood culture, neonatal sepsis, and mortality were documented.
Results: Most common isolated microorganism of endocervical culture were
Escherichia coli
(24.2%), Coagulase negative
Staphylococci
(27.2%),
Enterococcus
and
candida
each one (11.7%). The prevalence of GBS was only 2.2%.
Simultaneous positive blood cultures were seen in 3% of neonates. Among them,
Gram-negative bacilli accounted for (66.6%), while Gram-positive cocci and
candida made up only (16.7%). Endocervical colonization was associated with a
higher admission rate (p=0.004), but there was no significant correlation between
endocervical colonization and chorioamnionitis, positive blood culture and neonatal
mortality rate.
Conclusion: With regard to low GBS colonization rate, appropriate antibiotic
regimens should be considered in PPROM cases according to the most prevalent
micro organisms of endocervical bacterial colonization. Maybe cervical bacterial
colonization had some effects on neonatal outcomes. There was no significant
association between endocervical bacterial colonization and chorioamnionitis,
positive neonatal blood culture and neonatal mortality.
