NEONATAL SEPSIS AND PROLONGED RUPTURE OF M EMBRANES

Abstract

Background: Prolonged rupture of membranes (PROM) is considered when the duration of rupture of amniotic membranes is more than 18 hours prior to delivery. PROM is one of the common risk factors for early-onset neonatal sepsis. Timely identication of sepsis is important.The aim of the study was to determine the outcome and requirement of prophylactic use of antibiotics in newborns born to PROM. Materials & methods: A retrospective study on neonates born to mothers with PROM was conducted from December 2019 to December 2020. Total of 54 neonates fullling the inclusion criteria were included and their case records were evaluated for clinical and laboratory records as well as diagnosis and outcomes. Results: Out of 54 neonates, 30(55%) were males and 24(45%) females. 28 (51%) were full term and 26(49%) were pre term. Mode of delivery was vaginal in 32 (59%), and LSCS in 22 (41%). Clinical features suggestive of sepsis were present in Twenty-eight neonates (52%). Fever was the most common symptom seen in 13(46%) neonates followed by poor feeding in 9 neonates and tachypnoea in two neonates. C- reactive protein was positive in 20 (37%) neonates with a mean CRP value being 30 mg/dl. from which 14 (70%) had clinical signs. Twelve (22%) neonates required NICU admission and culturepositive sepsis was seen in ve (9%) neonates. E. coli was isolated in three neonates while Acinetobacter baumanii in two. Only one neonate succumbed. Conclusion: Conrmed sepsis was seen in a very low proportion of neonates born to mothers with prolonged rupture of membranes. Hence early sepsis screening and follow-up of neonates with clinical features suggestive of sepsis might decrease the use of prophylactic antibiotics.