Spectrum of High Vaginal Swab Isolates and Ultrasound for Evaluation of Cervical Factors in Prediction of Preterm Prelabour Rupture of Membrane
Authors/Creators
- 1. Resident, Dept of OBG, Agartala Govt Medical College, Tripura
- 2. Professor & HOD, Dept of OBG, Agartala Govt Medical College, Tripura
- 3. Asst Professor, Dept of OBG, Agartala Govt Medical College, Tripura
- 4. Professor & HOD, Dept of Microbiology, Agartala Govt Medical College, Tripura
Description
Background: PROM can cause significant maternal and fetal morbidity and mortality. PROM is an obstetric enigma and several other risk factors in addition to cervical factors and genital tract infection, have been implicated in its causation. Prediction and prevention of prelabour rupture of membrane would offer the best opportunity to prevent its complications. Objectives: The current study was undertaken to determine the spectrum of high vaginal swab isolates and ultrasound for evaluation of cervical factors in prediction of preterm prelabour rupture of membrane. Materials and Methods: This observational study was conducted in the department of Obstetrics and Gynaecology, AGMC Agartala, Tripura among 230 pregnant women attending the Obstetric OPD, based on certain inclusion and exclusion factors. All patient particulars and risk factors for PPROM like previous history of preterm birth or prelabour rupture of membrane were collected using a preformed questionnaire. High vaginal swab and USG to know cervical length was done once in each trimester. All patients were followed up to delivery. Associations between high vaginal swab findings and ultrasound findings and PPROM was looked into. Results: The mean (standard deviation) of age of the study population was 25.1 (4.2). History of preterm birth and history of abortion were present in 13.9% and 22.2% of the mothers respectively. The mean gestational age of the study population at PPROM, and at delivery were 29 and 29.6 weeks respectively. PPROM was seen in 6.5% of the study population. Thirty-five (15.2%) of the study population had chorioamnionitis. Neonatal sepsis was seen in 18.3% of the study population. Funnelling of the cervix is seen in 35.2% of the study population. It was present in only a third (30.7%) of mothers with no PPROM, while it was seen in all (100%) of patients with PPROM. The difference in the proportions were statistically significant. The mean cervical length in mothers with PPROM was significantly shorter than in mothers without PPROM. Cervix length less than 25 mm is seen in two-thirds of mothers with PPROM and Cervix length more than 25 mm one third of mothers with PPROM. The difference in the proportions were not statistically significant. Positive HVS are associated with PPROM in 93.3% of cases while a positive HVS was associated with no-PPROM in 89.3% of cases. All the HVS positive patients received conventional treatment as per departmental protocol. The difference between the proportions were not statistically significant. The most common organisms isolated in the no PPROM and PPROM groups were Staphylococcus aureus, (42.2 versus 40%) and E coli (23.9% versus 26.7%) respectively. Conclusion: This study has shown no significant difference in the spectrum of high vaginal swabs in mothers with and without PPROM. Significantly shorter length of cervix and presence of funnelling is seen in patients with PPROM as compared to mothers with no PPROM.
Abstract (English)
Background: PROM can cause significant maternal and fetal morbidity and mortality. PROM is an obstetric enigma and several other risk factors in addition to cervical factors and genital tract infection, have been implicated in its causation. Prediction and prevention of prelabour rupture of membrane would offer the best opportunity to prevent its complications. Objectives: The current study was undertaken to determine the spectrum of high vaginal swab isolates and ultrasound for evaluation of cervical factors in prediction of preterm prelabour rupture of membrane. Materials and Methods: This observational study was conducted in the department of Obstetrics and Gynaecology, AGMC Agartala, Tripura among 230 pregnant women attending the Obstetric OPD, based on certain inclusion and exclusion factors. All patient particulars and risk factors for PPROM like previous history of preterm birth or prelabour rupture of membrane were collected using a preformed questionnaire. High vaginal swab and USG to know cervical length was done once in each trimester. All patients were followed up to delivery. Associations between high vaginal swab findings and ultrasound findings and PPROM was looked into. Results: The mean (standard deviation) of age of the study population was 25.1 (4.2). History of preterm birth and history of abortion were present in 13.9% and 22.2% of the mothers respectively. The mean gestational age of the study population at PPROM, and at delivery were 29 and 29.6 weeks respectively. PPROM was seen in 6.5% of the study population. Thirty-five (15.2%) of the study population had chorioamnionitis. Neonatal sepsis was seen in 18.3% of the study population. Funnelling of the cervix is seen in 35.2% of the study population. It was present in only a third (30.7%) of mothers with no PPROM, while it was seen in all (100%) of patients with PPROM. The difference in the proportions were statistically significant. The mean cervical length in mothers with PPROM was significantly shorter than in mothers without PPROM. Cervix length less than 25 mm is seen in two-thirds of mothers with PPROM and Cervix length more than 25 mm one third of mothers with PPROM. The difference in the proportions were not statistically significant. Positive HVS are associated with PPROM in 93.3% of cases while a positive HVS was associated with no-PPROM in 89.3% of cases. All the HVS positive patients received conventional treatment as per departmental protocol. The difference between the proportions were not statistically significant. The most common organisms isolated in the no PPROM and PPROM groups were Staphylococcus aureus, (42.2 versus 40%) and E coli (23.9% versus 26.7%) respectively. Conclusion: This study has shown no significant difference in the spectrum of high vaginal swabs in mothers with and without PPROM. Significantly shorter length of cervix and presence of funnelling is seen in patients with PPROM as compared to mothers with no PPROM.
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Additional details
Dates
- Accepted
-
2023-05-25
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/15/IJPCR,Vol15,Issue7,Article63.pdf
- Development Status
- Active
References
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