Pathogenic microorganisms and perinatal outcomes of pregnant women with preterm premature ruptures of membranes prior to 34 weeks of gestation
OBJECTIVE To analyze the pathogenic bacteria of preterm premature rupture of membranes(PPROM)prior to 34 weeks of gestation and the maternal and neonatal outcomes,so as to provide references for clinical treatments.METHODS A total of 493 cases of pregnant women who gave birth from Jan.1,2012 to Jan.1,2021 in Peking University Third Hospital were selected and divided into the pathogen-positive group(n=158)and neg-ative group(n=335).The clinical surveillance,laboratory examination,treatment and the outcome of mothers and infants were investigated.The composition of pathogenic bacteria and their drug sensitivity were analyzed.RESULTS Among the 493 pregnant women,a total of 170 strains of pathogenic bacteria were isolated from 158 pregnant women by cervical secretion and placental swab culture with the detection rate of 32.05％,of which 96 strains(56.47％)were gram-negative bacteria and Escherichia coli,Klebsiella pneumoniae were common,54 strains(31.76％)were gram-positive and Streptococcus agalactiae was common,and 20 strains(11.76％)were fungi and Candida albicans was common.Among those pathogenic bacteria,E.coli had low resistance to cefoper-azone sulbactam sodium and etapenem,K.pneumoniae was sensitive to erapenem,Streptococcus was a little sen-sitive to penicillin.Compared with the control group,the gestational periods of premature membranes rupture in the pathogen-positive group were short(P＜0.05),the rates of cervical incompetence and gestational diabetes mellitus were high(P＜0.05);the expectant period for treatments was long(P＜0.05),the proportion of changing restrict-ed-and special-class antibiotics before delivery,and the diagnostic rate of intrauterine infection(12.03％),the in-cidences of neonatal pneumonia(37.97％)and sepsis(14.56％)were all high(P＜0.05).CONCLUSIONS E.co-li,K.pneumoniae,S.agalactiae and C.albicans are the most common pathogens of PPROM prior to 34 weeks of gestation.The infection-related complications in PPROM mothers can be effectively controlled by antibiotic therapy;however,the incidence of neonatal pneumonia is still very high.
Preterm premature rupture of membraneEtiological examinationAntibioticsClinical treatmentMaternal and fetal prognosis
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