Sepsis following premature rupture of membranes in Minoufiya neonatal intensive care unit

Premature rupture of amniotic membranes [PROM] is one of the serious complications of pregnancy, a relationship exists between prolonged PROM, chonoamnionitis and neonatal sepsis. The purpose of the present work was to identify percentage and risk factors for neonatal sepsis following PROM and to study the relationship between bacterial flora of women in labor [with and without rupture of membranes] and the results of blood culture of their septic neonates. Our study was carried on 100 neonates and their mothers. High vaginal, endocervical and anorectal swabs for bacterial culture were done to all mothers with or without PROM. Neonates were examined and investigated for sepsis diagnosis, in the first 72 hours after delivery. The incidence of neonatal sepsis following PROM in the present work was 25%. The most commonly isolated organism from the septic neonates was E-coli followed by Klebsiella while the least common organisms were Enterobacter and Diphteroid. The surface swabs of the babies matched with blood culture for the neonates irrespective of the condition of fetal membranes with no significant difference between neonates with PROM and without PROM. The mother lower genital tract swabs matched with blood cultured from the neonates with a significant difference between cases with PROM and without PROM. Prematurity was the major risk factor for early onset neonatal sepsis following PROM in our study. The mortality rates in septic neonates with PROM was 60% while that of neonates with sepsis without PROM was 37.5%. The prolonged duration of PROM offers time for the ascent of bacteria resulting in early onset neonatal sepsis especially in the presence of other risk factors for neonatal sepsis such as, prematurity and low apgar score. And the bacteria found in blood cultures of neonates with early onset sepsis following PROM are usually the same that found in the genital tract of their mothers