Microbiological findings in pregnant women with premature rupture of the membranes

Abstract

From 30 consecutive cases of premature rupture of the membranes (PROM) and matched controls, specimens from urine, cervix, amniotic fluid, and placenta as well as neonatal nose and throat swabs were investigated bacteriologically and virologically. In addition virus serological investigation was done. Among the PROM cases the anaerobic cervical isolates outnumbered the aerobic ones, and the total number of aerobic as well as anaerobic isolates was less in the control group. The anaerobes B. fragilis and Strept. intermedius were isolated from the cervix, amniotic fluid, or placenta in 23% and 30% of the PROM patients, respectively. None of the controls harboured B. fragilis, while Strept. intermedius was isolated from 6.7% of the controls. Group B streptococci were recovered from the mother's cervix in 20% of the PROM patients and in 6.7% among the controls. Four cases of neonatal septicaemia were encountered, and another two cases were clinically suspected, but not microbiologically verified, contributing to a high perinatal mortality rate (17,6%). Of the PROM patients, 27% developed puerperal infection, while none of the control mothers had such complications. The significance of the anaerobic bacteria as well as group B streptococci for the maternal and neonatal outcome in cases of PROM is discussed, and a possible aetiological role of ascending infection in this complication of pregnancy is postulated.