26Jun 2017

Effect of three regimens of prophylactic antibiotics in pregnant women with preterm premature rupture of fetal membranes: A randomised comparative study.

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Background: The benefit of prophylactic antibiotic therapy in preterm PROM is well established by several trials however data relating to prophylactic antibiotics in Indian women is limited which might be due to difference in the microbiological flora of the Indian women from the western women. The present work was done with an aim to assess the effect of three different regimens of prophylactic antibiotics in pregnant women with pPROM on maternal and neonatal morbidity and mortality. Methods: Pregnant women with pPROM between 28 to 34 weeks (n=150) were randomised into three equal groups (n=50) of prophylactic antibiotics regimens. Group 1 received Inj Ampicillin 1gm IV 6 hrly for 48 hrs followed by amoxicillin 500mg orally 8hrly for 5 days. Group 2 received oral erythromycin 250 mg 8hrly for 7 days and Group 3 received Ampicillin 1gm IV 6 hourly + Metronidazole 500 mg IV 8 hourly for 48 hrs followed by amoxicillin 500mg orally 8hrly for 5 days. The period from rupture of membranes to delivery (Latency) was calculated and the maternal - neonatal outcome was compared between these groups. Results: The latent period between rupture of membranes and delivery was significantly longer in the women who received only Inj Ampicillin (Group 1) and combination of Inj. Ampicillin with metronidazole (Group 3) compared to women who received oral erythromycin (8.92 ? 7.12 and 9.34 ? 9.17 days vs. 6.18 ? 6.11 days; p=0.005). However the difference in the latent period between Ampicillin and Ampicillin with metronidazole group was non-significant (8.92 ? 7.12 vs. 9.34 ? 9.17; p= 0.482). The frequency of maternal complications like clinical chorioamnionitis was significantly higher (6%) in women who received erythromycin compared to the women who received ampicillin (0%) and ampicillin + metronidazole (0%), the difference was highly significant (p= 0.047).Though the difference in the rates of puerperal sepsis, PPH, neonatal sepsis, intraventricular haemorrhages and neonatal mortality was insignificant. Conclusion:The use of prophylactic antibiotic either single ampicillin or in combination ampicillin+ metronidazole in preterm PROM significantly prolongs gestation and appears to decrease maternal morbidity due to chorioamnionitis and hence proved to be more efficacious over erythromycin .

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[Geetika Arora, S. S. Trivedi, Sharda Patra and Manisha. (2017); Effect of three regimens of prophylactic antibiotics in pregnant women with preterm premature rupture of fetal membranes: A randomised comparative study. Int. J. of Adv. Res. 5 (Jun). 1998-2004] (ISSN 2320-5407). www.journalijar.com

Dr. Geetika Arora

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Article DOI: 10.21474/IJAR01/4633      
DOI URL: http://dx.doi.org/10.21474/IJAR01/4633

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