Preterm premature rupture of membranes: results of expectant management in patients with cervical cultures positive for group B streptococcus or Neisseria gonorrhoeae.

Abstract

The antepartum course and short-term neonatal outcome for patients with premature rupture of membranes between 26 and 33 weeks' gestation with positive cervical cultures for group B streptococcus or Neisseria gonorrhoeae were reviewed. A retrospective analysis of 182 patients managed expectantly over a 3-year period was done. Thirty-four patients had cervical cultures positive for group B streptococcus, 11 had positive cultures for Neisseria gonorrhoeae, and 137 had negative cultures. Prophylactic antibiotics were routinely given, and antibiotic therapy was continued in patients with positive cultures. There was no difference between groups in latent phase or maternal morbidity. The incidence of neonatal pneumonia was increased in those with positive cervical cultures (p = 0.009, odds ratio 6.9, 90% confidence interval 2.1 to 22.8), but there was no difference in neonatal sepsis, respiratory distress, or neonatal mortality. These data support the conservative or expectant management of premature rupture of membranes between 26 and 33 weeks in patients with positive cervical cultures who are given prophylactic antibiotic therapy.