title: Mean gestation at delivery and histological chorioamnionitis correlates with early-onset neonatal sepsis following expectant management in pPROM.
abstract: This prospective observational study was carried out in India among 100 women with preterm pre-labour rupture of membranes (pPROM) between 26(0/7)-33(0/7) weeks on expectant management in order to correlate early-onset neonatal sepsis (EONS) with various features of chorioamnionitis. The incidence of pPROM during the study period of 1.5 years was 7%. The mean gestation at pPROM was 30(6/7) ± 1.8 weeks and at delivery was 32(1/7) ± 1 weeks. Features of chorioamnionitis in the form of clinical, microbiological, histological or a combination of these were observed in 70/100 women. Clinical chorioamnionitis was seen in 16%, bacterial isolates were present in 30% on cervical swab and in 39% on placental membrane culture and 19% had histological chorioamnionitis. EONS was present in 23/97 (24%). Clinical chorioamnionitis (p = 0.069), bacterial isolates on cervical swab (p = 0.56) or placental membranes (p = 0.39) were not found to predict EONS; whereas histological chorioamnionitis (p = 0.002) and lower gestation at delivery (p = 0.013) were significantly associated with EONS.
authors.affiliation: Department of Obstetrics and Gynaecology, Post Graduate Institute of Medical Education and Research , Chandigarh , India.
authors.forename: P
authors.initials: P
authors.lastname: Arora
authors.forename: R
authors.initials: R
authors.lastname: Bagga
authors.forename: J
authors.initials: J
authors.lastname: Kalra
authors.forename: P
authors.initials: P
authors.lastname: Kumar
authors.forename: S
authors.initials: S
authors.lastname: Radhika
authors.forename: V
authors.initials: V
authors.lastname: Gautam
mesh_terms: D000328:Adult; D002584:Cervix Uteri / Q000382:microbiology; D002821:Chorioamnionitis / Q000382:microbiology / Q000473:pathology*; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000453:epidemiology* / Q000628:therapy*; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D000071074:Neonatal Sepsis / Q000453:epidemiology* / Q000382:microbiology; D010920:Placenta / Q000382:microbiology; D011247:Pregnancy; D011446:Prospective Studies; D013997:Time Factors; D057832:Watchful Waiting; D055815:Young Adult
keywords: Clinical chorioamnionitis; EONS; expectant management; histological chorioamnionitis; microbiological chorioamnionitis; pPROM