[Evaluation of materno-foetal ifectious risk after isolated premature rupture of memebranes in at term new-born]

ABSTRACT

Premature rupture of membranes [PROM] is defined as rupture of membranes occurring before the onset of labor. It complicates 5 to 10% of pregnancies. It continues to be a major cause of morbidity and mortality in the newborn. To evaluate infectious risk associated with PROM in at term and asymptomatic new-born and to study this risk according to the duration of rupture. Retrospective study in neonatal unit of Charles Nicolle hospital of Tunis including all cases with isolated PROM in at term new-born during the year 2007. 299 cases were identified over 3749 live births that is an incidence of 8%, divided to 21 cases [7%] between 6 and 12 hours, 86 cases [28.8%] between 12 and 18 hours, 61 cases [20.4%] between 18 and 24 hours and 131 cases [43.8%] more than 24 hours. Diagnosis of colonization was reported in 54% of cases when PROM occurred between 12 and 18 hours versus respectively 27.3%, 0% and 18% in respectively subset of 6 to 12 hours, 18 to 24 hours and more than 24 hours [p=0,03]. 62% of foeto-maternel infections were reported in subset of PROM more than 24 hours and 13.8% in the subset between 18 and 24 hours. Our study emphasizes the important risk of foetomaternel infection associated with isolated PROM. This risk is major when the rupture exceed 12 hours but the limit of 18 hours can unrecognized some cases of probable foeto-maternel infection