A CASE STUDY ON 3 WEEKS PREMATURE RUPTURE OF MEMBRANES CAUSED BY OROPHARYNGEAL MICROBIOTA

  • AREEFA SM ALKASSEH Department of Midwifery, Faculty of Nursing College, Islamic University of Gaza, Gaza, Palestine,
  • SHAIMAA JAMAL ALKHATIB Department of Nursing, Faculty of Nursing College, Islamic University of Gaza, Gaza, Palestine.

Abstract

Premature rupture of membrane (PROM) is produced when amniotic membranes tear before labor onset and is recorded in around 8 % of full-term gestations. Preterm PROMs (PPROMs) take place before the 37th week of gestation, with an incidence of 2–4 % of pregnancies, and it is associated with higher maternal and perinatal morbidity and mortality, mainly related to infectious processes and prematurity. Among maternal complications, which include postpartum infection, premature placental detachment, and maternal sepsis, we highlight clinical chorioamnionitis for its incidence and severity. Of decreasing frequency, perinatal complications include respiratory distress, neonatal sepsis, intraventricular hemorrhage, necrotizing enterocolitis, and neurological lesions. Full-term PROM frequently has a physiological cause and is a consequence of uterine contractions; however, PPROM usually has a multifactorial etiology that is often unknown, although the most frequently reported cause is an infection, observed in up to 60 % of cases. Therefore, the etiology of PPROM, although probably infectious, remains unknown in most cases. The obstetric approach varies as a function of gestational age, actively inducing the pregnancy in full-term PROM but performing an overall evaluation of maternal-fetal status in PPROM. In the latter situation, an assessment is made of the relative risks and benefits of a wait-and-see attitude versus pregnancy induction, considering signs of infection and/or prematurity, and ordering antibiotic treatment when PPROM is diagnosed . Multiple combinations of antimicrobial drugs have been proposed and better perinatal and maternal outcomes have been reported for the prophylactic administration of some new combinations. This study describes a case of PPROM caused by urinary tract infection.

Keywords: Maternal, Membrane, Premature, Rupture

References

1. ACOG Committee on Practice Bulletins-Obstetrics. ACOG Practice Bulletin No. 80: Premature rupture of membranes. Clinical management guidelines for obstetrician-gynecologists. Obstet Gynecol 2007;109:1007-19.
2. RCOG Green-Top Guideline No. 44. Preterm Prelabour Rupture of Membranes; 2010.
3. Romero R, Quintero R, Oyarzun E, Wu YK, Sabo V. Intraamniotic infection and the onset of labor in preterm premature rupture of the membranes. Am J Obstet Gynecol 1988;159:661-6.
4. Cobo T, Palacio M, Martínez-Terrón M, Navarro-Sastre A, Bosch J, Filella X, et al. Clinical and inflammatory markers in amniotic fluid as predictors of adverse outcomes in preterm premature rupture of membranes. Am J Obstet Gynecol 2011;205:126.e1-8.
5. Dare MR, Middleton P, Crowther CA, Flenady VJ, Varatharaju B. Planned early birth versus expectant management (waiting) for prelabour rupture of membranes at term (37 weeks or more). Cochrane Database Syst Rev 2006;1:CD005302.
6. ACOG practice bulletin No. 107: Induction of labor. Obstet Gynecol 2009;114:386-97.
7. Kenyon SL, Taylor DJ, Tarnow-Mordi W, ORACLE Collaborative Group. Broad-spectrum antibiotics for preterm, prelabour rupture of fetal membranes: The ORACLE I randomised trial. ORACLE collaborative group. Lancet 2001;357:979-88.
9. Vytla S, Mendz G, Quinlivan J. Dental bacterial DNA are present in the amniotic cavity of healthy pregnant women at term. Transl Med 2016;6:181.
10. Kaakoush N, Quinlivan J, Mendz G. Bacteroides and Hafnia infections associated with chorioamnionitis and preterm birth. J Clin Gynecol Obstet 2014;3:76-9.
11. Mendz GL, Petersen RW, Quinlivan JA, Kaakoush NO. Potential involvement of Campylobacter curvus in preterm birth. BMJ Case Rep 2014;10:1136.
12. Lee J, Romero R, Kim SM, Chaemsaithong P, Yoon BH. A new antibiotic regimen treats and prevents intra-amniotic inflammation/infection in patients with preterm PROM. J Matern Fetal Neonatal Med 2016;29:2727-37.
13. Lee J, Romero R, Kim SM, Chaemsaithong P, Park CW, Park JS, et al. A new anti-microbial combination prolongs the latency period, reduces acute histologic chorioamnionitis as well as funisitis, and improves neonatal outcomes in preterm PROM. J Matern Fetal Neonatal Med 2016;29:707-20.
14. Available from: https://www.emedicine.medscape.com/article/261137-overview.
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SM ALKASSEH, A., & ALKHATIB, S. J. (2021). A CASE STUDY ON 3 WEEKS PREMATURE RUPTURE OF MEMBRANES CAUSED BY OROPHARYNGEAL MICROBIOTA. Innovare Journal of Health Sciences, 9(2), 1-2. https://doi.org/10.22159/ijas.2021.v9i2.40854
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Case Study(s)