[Determining the frequency of neonatal sepsis based on premature rupture of membrane [PROM] -scoring system at Mahdieh Hospital in Tehran]

ABSTRACT

Premature rupture of membranes [PROM] increases the rate of neonatal sepsis. Using a clinical guideline for initiating the laboratory evaluation and treatment of such neonates, for instance PROM-Scoring system, particularely in developing countries in which the availability of rapid and accurate clinical conveniences are limited, may surprisingly result in reducing the antibiotic consumption, hospital charges and neonatal morbidity. We performed this survey to outline these issues. In this cross-sectional study 270 newborns of whom were born 18 hours or more after PROM were enrolled and studied at Mahdieh hospital for a one year period. The neonates underwent a thorough evaluation and the symptomatic ones were treated for sepsis, whereas the asymptomatc newborns and the ones with a PROM score of less than 3 went under a in-hospital supervision for 3 days. Among the studied newborn, 79 cases were symptomatic and 199 were symptom free. The threshold score of 3 was of an accurate specificity [100%] in diagnosing the affected infants. All the asymptomatic ones have a score below 3. Five cases developed several symptoms mostly during their first 12 hours of lives whom were considered as having sepsis and, therefore, were assessed and treated. None of asymptomatic cases were referred again after their discharge thus far. 14 neonates [5.2%] who all weighed less than 2500gr, died due to either RDS, Asphyxia or congenital anomalies. Based on the achieved results we suggest all the symptomatic newborns and the asymptomatic ones with PROM score of above 3 to be precisely evaluated and consequently treated for sepsis, whereas for asymptomatic infants with a score of less than 3 a 24-72 hours of in-hospital supervision is sufficient