Microbial Pattern In Amniotic Fluid And Histology Of The Smooth Chorion In Women With Premature Rupture Of Membranes And Preterm Premature Rupture Of Membranes At The Kenyatta National Hospital

Abstract

Background:Premature membrane rupture complicates 2% of pregnancies but is linked with 40% of premature delivery and high perinatal morbidity and mortality. Ascending genital infections have been associated with occurrence of premature membrane rupture. Multiple pathogens are implicated. Objective: To examine the associations between amniotic fluid microbial growth and the histology of the smooth chorion of the placenta with pregnancy outcomes among women with PROM and PPROM. Methods: This was a prospective cohort study conducted at the Kenyatta National Hospital labour ward between May and August 2018. A total of 50 women were recruited, 29 with preterm premature rupture of membranes, and 21 with rupture of membranes at term. Eligible mothers were interviewed to obtain medical history, and physical examination performed. High vaginal swab/ amniotic fluid samples were collected for microscopy culture and sensitivity. The placentae were collected at delivery for histology. Placental pathological changes and amniotic fluid bacteriology were the exposure variables. Clinical outcomes (maternal disease, neonatal disease) were the outcome variables. Results: Women with PPROM had a mean age of 25.7 years; the mean age for PROM was 29.2 years. (p= 0.017). Among women with PPROM, candida species (17.2%), Group B streptococcus (13.8%) and E.coli (10.3%), were the most common microbes, while in PROM,candida (19.1%), Group B streptococcus (14.3%), E.coli (5%), E. faecalis (5%) were isolated.Group B streptococcus .......