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Comparative efficacy of two prophylactic antibiotic regimens on the maternal and neonatal outcomes in pregnancy with preterm premature rupture of membrane

Lavanya Pawar, Narayana S Reddy.




Abstract

Background: Preterm premature rupture of membrane (PPROM) is rupture of fetal membrane before 37 weeks of gestation. Antibiotic use is known to increase the latency period and seems to reduce the rates of neonatal infection, the need of surfactants and postnatal oxygen therapy.

Aim and objective: The aim of the study was to assess the maternal and neonatal outcomes in women with PPROM receiving either cefotaxime or combination of cefotaxime with Metronidazole.

Materials and Methods: A total of 60 pregnant women of 24–36 weeks gestation diagnosed with PPROMs receiving prophylactic antibiotics either cefotaxime (regimen 1) or combination of cefotaxime with metronidazole (regimen 2) were included in study. Details regarding the duration of ROM, prophylactic antibiotics used were recorded. All women were then followed up after delivery. Both maternal and neonatal outcomes were assessed and analyzed.

Results: Total number of neonatal intensive care unit admissions was 40 out of 60 newborns. Patient treated with regimen 2 had less number of newborn with sepsis (38%) compared to regimen 1 (62%). Chorioamnionitis was diagnosed in (6 vs. 3, P = 0.298) women in regimen 1 compared to regimen 2 respectively. Women who developed postpartum sepsis was (6 vs. 4, P = 0.50) more in regimen 1 compared to that in regimen 2.

Conclusion: Antibiotic treatment with the regimen 2 had less number of maternal and neonatal complications compared to regimen 1. Addition of metronidazole along with cefotaxime will confer better coverage of anaerobic organisms responsible for various maternal and fetal infections.

Key words: Preterm Premature Rupture of Membrane; Chorioamnionitis; Cefotaxime; Neonatal Sepsis






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