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.

Keywords::

• Clinical chorioamnionitis
• EONS
• expectant management
• histological chorioamnionitis
• microbiological chorioamnionitis
• pPROM

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.