Prophylactic antibiotic treatment duration in preterm premature rupture of membrane 7 days versus until delivery

Abstract

BACKGROUND: Preterm prelabour rupture of membrane(PPROM) accounts for 2-3% of all complicated pregnancies and is one of the major causes of preterm deliveries. AIM AND OBJECTIVE:To evaluate and compare maternal and neonatal outcomes in women with PPROM treated with prophylactic antibiotics for 7 days versus until delivery. MATERIALS AND METHOD:A total of 110 pregnant women of 26 weeks 0 days to 36 weeks 6 days gestation diagnosed with PPROM receiving prophylactic antibiotics for 7 days(Group1) and until delivery(Group2) were included in study. Details regarding the duration of ROM, prophylactic antibiotics used were recorded. Both maternal and neonatal outcomes were assessed and analyzed. RESULTS:There was a notable difference in the incidence of persistent amniotic fluid leakage between the two groups. 56.3% of patients who received a 7-day antibiotic treatment experienced active leakage and 81.8% was seen in the antibiotics-until-delivery group. This difference was found to be statistically major(p<0.002). CPAP was not required in 74.5% of Group1 and 72.7% of Group2. A larger number of newborns of Group1 needed HFNC support compared to Group2(p=0.015). 72.7% of Group1 didn’t need O2 hood and 83.6% in Group2. There was a notable difference between the two groups(p = 0.037; χ2 = 6.6, df = 2), suggesting that how long the antibiotics are given might impact needing oxygen support in neonates. 52.7% needed hospital stay for 1-3 days, in Group1 and 30.9% in Group2 with a statistical significance of (p = 0.048). CONCLUSION: A 7-day course of prophylactic antibiotics treatment in PPROM is as effective as continued therapy until delivery with benefits of reduced hospital stay and antibiotic associated risks.