Bacteriological Study of Endocervix in Preterm Labour and Preterm Premature Rupture of Membranes

Pre term labour is the one which is challenging the safe motherhood practices and causing more peri natal morbidity and mortality in India. AIMS 1. To study the association of maternal demographic factors and spectrum of bacteria from Endocervical swab culture in patients with Preterm labour, Preterm premature rupture of membranes.2. To study maternal and fetal outcome and complications associated with preterm labour and preterm premature rupture of membranes. The present study was done in 130 patients demographic factors like occupation, education, socio economic status, body mass index, passive smoking were taken and cervical swabs was taken for cultural sensitivity and patients complaining of preterm labour, PTL, PPROM and TPTL were in between 21-25 yrs. PTL (Preterm Labour), PPROM (Preterm Premature Rupture Of Membranes) and TPTL (Threatened Preterm Labour) was found to be more common in housewives who were primigravidae in the gestational age of 34-36 weeks, was common among primary school and middle school, belongs to upper lower socio-economic status. Risk of PPROM is associated with low BMI less than18.5. This indicates the need to improve low BMI before conception. None of the women in the study population were smokers. But passive smoking is associated with PTL, PPROM & TPTL. A higher percentage of previous PTL was found in the PTB (Preterm Birth) group than PPROM. Out of 130 cases of cervical swab cultures, 54 were positive in the study group. E. coli, staph. aureus, klebsiella, strep. agalactiae, enterococcus, diptheroids and mixed organisms. There was no case of clinical chorioamnionitis in the present study. Amikacin gentamycin and imipenem were found to be effective antibiotics for most of the organisms. Resistance to ampicillin and cefotaxime was noted. Normal vaginal delivery was the commonest mode of delivery. Out of 8 cases of TPTL all cases were conserved (not delivered). Out of 122 births, 39 babies needed NICU admission due to prematurity and different complications like RDS (Respiratory Distress Syndrome), NS (Neonatal Sepsis), BA (Birth Asphyxia), MAS (Meconeum aspiration syndrome), NC (Neonatal Convulsions). Neonatal death was seen in 14 neonates out of 122 births. Conclusion Timely detection and treatment is important to avoid prematurity, associated neonatal morbidity and mortality.