Figure 1. Suggested protocol of management of neonates born to mothers with prolonged rupture of membranes.
| Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access |
| Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc |
| Journal website http://www.jocmr.org |
Original Article
Volume 11, Number 5, May 2019, pages 360-366
Prolonged Rupture of Membranes, Neonatal Outcomes and Management Guidelines
Figure
Tables
| Character | Distribution |
|---|---|
| Gestational age (mean ± SD) | 36 ± 1.7 |
| Birth weight (mean ± SD) | 2,767 ± 777 |
| Small for age (number/%) | 9/5 |
| Male gender (number/%) | 126/71.66 |
| Cesarean section delivery (number/%) | 81/46.0 |
| Apgar scores (mean) | |
| First min | 7 |
| Fifth min | 9 |
| Characteristic | Number (frequency) |
|---|---|
| PROM: prolonged rupture of membranes; UTI: urinary tract infection; GBS: group B streptococcus. | |
| PROM | |
| PROM < 2 days | 101 (57.3) |
| PROM 2 - 6 days | 36 (20.5) |
| PROM > 7 days | 39 (22.2) |
| Maternal UTI | 26 (14.8) |
| Unknown GBS status | 176 (100) |
| Maternal chorioamnionitis | 2 (1.1) |
| Peripartum maternal fever | 9 (5.0) |
| Characteristic | Number (frequency) |
|---|---|
| WBC: white blood cell; CRP: C-reactive protein. | |
| Status at birth | |
| Well | 131 (74.4) |
| Ill | 4 (2.3) |
| Equivocal | 45 (25.6) |
| WBC > 25,000 | 7 (4.0) |
| WBC < 5,000 | 2 (1.1) |
| Thrombocytopenia | 11 (6.3) |
| CRP baseline positive | 11/56 (19.6) |
| CRP positive at 48 h | 40/147 (27.2) |
| Blood culture positive | 9 (5.1) |
| Length of hospital stay (average ± SD) | 5 ± 3 |
| Mortality | 1 (0.57) |
| Characteristics | Newborns with sepsis (n = 32) | Normal newborns (n = 144) | P value |
|---|---|---|---|
| SGA: small for gestational age; PROM: prolonged rupture of membranes; WBC: white blood cell; CRP: C-reactive protein. | |||
| Well | 19 (59.3) | 100 (69.4) | 0.270 |
| Ill | 4 (12.5) | 0 (0.0) | 0.000 |
| Equivocal | 9 (28.1) | 36 (25) | 0.713 |
| Sepsis calculator recommendation | |||
| Empirical antibiotics recommended | 13 (40.6) | 31 (21.5) | 0.240 |
| Strongly recommended antibiotics | 1 (3.1) | 2 (1.4) | 0.492 |
| Blood culture recommended | 1 (3.1) | 11 (7.6) | 0.359 |
| Vital signs every 4 h | 3 (9.4) | 25 (17.4) | 0.263 |
| Routine care recommended | 16 (50.0) | 75 (52.1) | 0.831 |
| Gestational age (average) | 36 ± 1.7 | 36 ± 1.7 | 1.0 |
| SGA | 3 | 6 | 0.226 |
| Male gender | 81 | ||
| Cesarean section | 16 | 65 | 0.617 |
| Apgar score (first/fifth min) | 8/9 | 8/9 | |
| Urinary tract infection | 6 | 20 | 0.483 |
| Fever | 2 | 7 | 0.746 |
| Chorioamnionitis | 1 | 1 | 0.240 |
| Any antibiotic before delivery | 13 (40.6) | 34 (23.6) | 0.049 |
| PROM ≤ 2 days | 20 | 81 | 0.517 |
| PROM 2 - 6 days | 3 | 22 | 0.386 |
| PROM ≥ 7 | 8 | 31 | 0.668 |
| WBC > 25,000 | 0 | 7 | 0.669 |
| WBC < 5,000 | 1 (3) | 2 (1.4) | 0.492 |
| Platelets < 150 | 5 | 11 | 0.115 |
| CRP baseline positive | 2/7 (28.6) | 11/52 (21.2) | 0.656 |
| CRP positive at 48 h | 14/26 (43.8) | 38/138 (27.54) | 0.008 |
| Blood culture positive | 9 | 0 | 0.000 |
| Length of hospital stay (average ± SD) | 10 ± 3 | 4 ± 2 | 0.000 |
| Mortality | 0 | 1 | 0.240 |