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Prolonged Rupture of Membranes, Neonatal Outcomes and Management Guidelines

BACKGROUND: Prolonged rupture of membranes (PROM) is a risk factor for early-onset neonatal sepsis (EOS). In the absence of early specific and sensitive diagnostic tools, management of asymptomatic infants is difficult. This study was conducted to investigate clinical outcomes of newborns born to mo...

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Autores principales: Al-lawama, Manar, AlZaatreh, Ala, Elrajabi, Rawan, Abdelhamid, Sultan, Badran, Eman
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elmer Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6469888/
https://www.ncbi.nlm.nih.gov/pubmed/31019631
http://dx.doi.org/10.14740/jocmr3809
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author Al-lawama, Manar
AlZaatreh, Ala
Elrajabi, Rawan
Abdelhamid, Sultan
Badran, Eman
author_facet Al-lawama, Manar
AlZaatreh, Ala
Elrajabi, Rawan
Abdelhamid, Sultan
Badran, Eman
author_sort Al-lawama, Manar
collection PubMed
description BACKGROUND: Prolonged rupture of membranes (PROM) is a risk factor for early-onset neonatal sepsis (EOS). In the absence of early specific and sensitive diagnostic tools, management of asymptomatic infants is difficult. This study was conducted to investigate clinical outcomes of newborns born to mothers with PROM. METHODS: A retrospective study of neonates ≥ 34 weeks admitted due to PROM was conducted. Medical charts were reviewed. Neonates were classified into three categories based on their status at birth: ill appearing, well, and equivocal. Sepsis risk calculator was retrospectively applied. RESULTS: A total of 176 neonates were included. All mothers had unknown group B streptococcus (GBS) status. Of them, 74.4% were asymptomatic. Nine infants (5%) had positive cultures, and 23 infants (13%) had culture-negative sepsis. The newborns with sepsis fit into the “ill appearing” category with a significantly higher proportion (12.5% vs. 0.0%, P value < 0.0). CONCLUSIONS: Reliable early diagnostic tools for neonatal sepsis are lacking. Adopting a protocol that utilizes multiple methods and follow-up for the clinical condition of these infants are the key factors to avoid missing neonates with true sepsis and decreasing the use of antibiotics in those without infection.
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spelling pubmed-64698882019-04-24 Prolonged Rupture of Membranes, Neonatal Outcomes and Management Guidelines Al-lawama, Manar AlZaatreh, Ala Elrajabi, Rawan Abdelhamid, Sultan Badran, Eman J Clin Med Res Original Article BACKGROUND: Prolonged rupture of membranes (PROM) is a risk factor for early-onset neonatal sepsis (EOS). In the absence of early specific and sensitive diagnostic tools, management of asymptomatic infants is difficult. This study was conducted to investigate clinical outcomes of newborns born to mothers with PROM. METHODS: A retrospective study of neonates ≥ 34 weeks admitted due to PROM was conducted. Medical charts were reviewed. Neonates were classified into three categories based on their status at birth: ill appearing, well, and equivocal. Sepsis risk calculator was retrospectively applied. RESULTS: A total of 176 neonates were included. All mothers had unknown group B streptococcus (GBS) status. Of them, 74.4% were asymptomatic. Nine infants (5%) had positive cultures, and 23 infants (13%) had culture-negative sepsis. The newborns with sepsis fit into the “ill appearing” category with a significantly higher proportion (12.5% vs. 0.0%, P value < 0.0). CONCLUSIONS: Reliable early diagnostic tools for neonatal sepsis are lacking. Adopting a protocol that utilizes multiple methods and follow-up for the clinical condition of these infants are the key factors to avoid missing neonates with true sepsis and decreasing the use of antibiotics in those without infection. Elmer Press 2019-05 2019-04-14 /pmc/articles/PMC6469888/ /pubmed/31019631 http://dx.doi.org/10.14740/jocmr3809 Text en Copyright 2019, Al-lawama et al. http://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution Non-Commercial 4.0 International License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Al-lawama, Manar
AlZaatreh, Ala
Elrajabi, Rawan
Abdelhamid, Sultan
Badran, Eman
Prolonged Rupture of Membranes, Neonatal Outcomes and Management Guidelines
title Prolonged Rupture of Membranes, Neonatal Outcomes and Management Guidelines
title_full Prolonged Rupture of Membranes, Neonatal Outcomes and Management Guidelines
title_fullStr Prolonged Rupture of Membranes, Neonatal Outcomes and Management Guidelines
title_full_unstemmed Prolonged Rupture of Membranes, Neonatal Outcomes and Management Guidelines
title_short Prolonged Rupture of Membranes, Neonatal Outcomes and Management Guidelines
title_sort prolonged rupture of membranes, neonatal outcomes and management guidelines
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6469888/
https://www.ncbi.nlm.nih.gov/pubmed/31019631
http://dx.doi.org/10.14740/jocmr3809
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