title: Is There a Role for Placental Cultures in Cases of Clinical Chorioamnionitis Complicating Preterm Premature Rupture of Membranes?
abstract: ObjectiveTo assess the role of placental cultures in cases of preterm premature rupture of membranes (PPROM) complicated by chorioamnionitis and to determine the effect of positive cultures on short-term neonatal outcomes.DesignA retrospective single-center study. The medical records of all women with PPROM between January 1, 2011, and December 31, 2015, were reviewed. Cases were divided into placental culture positive (group A) and placental culture negative (group B) groups. Maternal and pregnancy characteristics as well as short-term neonatal outcomes were compared between groups.ResultsDuring the 5-year study period, 61 cases of clinical chorioamnionitis complicating PPROM were diagnosed: 25 cases were culture positive (group A) and 36 were culture negative (group B). Neonatal outcome measures, including Apgar score at 5 minutes (p= 0.028; odds ratio [OR]: 5.27; confidence interval [CI]: 1.19-23.34), respiratory distress syndrome (p= 0.026; OR: 4.11; CI: 1.18-14.25), and neonatal infection (p< 0.0001; OR: 11.59; CI: 3.37-39.87) were significantly more common in group A newborns, regardless of gestational age at delivery as was the composite neonatal outcome (p= 0.017; OR: 7.35: CI: 1.42-37.79). Placental isolates were primarilyStreptococciandEscherichia coli.ConclusionPlacental cultures may be an essential predictor of neonatal morbidity in PPROM and may contribute to the modification of neonatal treatment.
authors.affiliation: Department of Obstetrics and Gynecology, Sourasky Medical Center, Tel Aviv University, Lis Maternity Hospital, Tel Aviv, Israel.
authors.forename: Yuval
authors.initials: Y
authors.lastname: Fouks
authors.affiliation: Department of Obstetrics and Gynecology, Sourasky Medical Center, Tel Aviv University, Lis Maternity Hospital, Tel Aviv, Israel.
authors.forename: Ariel
authors.initials: A
authors.lastname: Many
authors.affiliation: Neonatal Intensive Care Unit, Department of Neonatology, Dana Dwek Children's Hospital, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Rotem
authors.initials: R
authors.lastname: Orbach
authors.affiliation: Tel Aviv University, Sackler School of Medicine, Tel Aviv, Israel.
authors.forename: Udi
authors.initials: U
authors.lastname: Shapira
authors.affiliation: Infectious Disease Unit, Sourasky Medical Center, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Sharon
authors.initials: S
authors.lastname: Amit
authors.affiliation: Pediatrics Infectious Diseases Unit, Dana-Dwek Children's Hospital, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Galia
authors.initials: G
authors.lastname: Grisaru-Soen
authors.affiliation: Neonatal Intensive Care Unit, Department of Neonatology, Dana Dwek Children's Hospital, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Dror
authors.initials: D
authors.lastname: Mandel
authors.affiliation: Department of Obstetrics and Gynecology, Sourasky Medical Center, Tel Aviv University, Lis Maternity Hospital, Tel Aviv, Israel.
authors.forename: Shiri
authors.initials: S
authors.lastname: Shinar
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D001034:Apgar Score; D001424:Bacterial Infections / Q000175:diagnosis* / Q000188:drug therapy; D002821:Chorioamnionitis / Q000188:drug therapy / Q000382:microbiology*; D004926:Escherichia coli / Q000302:isolation & purification; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000188:drug therapy / Q000382:microbiology*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007557:Israel; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D010920:Placenta / Q000382:microbiology*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy / Q000382:microbiology*; D011256:Pregnancy Outcome; D012127:Respiratory Distress Syndrome, Newborn / Q000209:etiology; D012189:Retrospective Studies; D013291:Streptococcus / Q000302:isolation & purification
chemical_list: D000900:Anti-Bacterial Agents