Invasión microbiana de la cavidad amniótica en la rotura de membranas de pretérmino: Resultados maternoneonatales y patología placentaria según microorganismo aislado

Background: Microbial invasion of amniotic cavity occurs in 30 to 50% of patients with premature membrane rupture. Aim: To determine the outcomes associated with microbial invasion of the amniotic cavity (MIAC) in patients with preterm premature rupture of membrane (pPROM). Patients and methods: One...

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Autores principales:	Ovalle S,Alfredo, Gómez M,Ricardo, Martínez T,M. Angélica, Kakarieka W,Elena, Fuentes G,Ariel, Aspillaga M,Carlos, Ferrand M,Pedro, Ramírez F,Carlos
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2005
Materias:	Amniotic fluid Fetal membranes premature rupture Labor complications Premature birth
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872005000100007
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spelling	oai:scielo:S0034-988720050001000072014-08-12Invasión microbiana de la cavidad amniótica en la rotura de membranas de pretérmino: Resultados maternoneonatales y patología placentaria según microorganismo aisladoOvalle S,AlfredoGómez M,RicardoMartínez T,M. AngélicaKakarieka W,ElenaFuentes G,ArielAspillaga M,CarlosFerrand M,PedroRamírez F,Carlos Amniotic fluid Fetal membranes premature rupture Labor complications Premature birth Background: Microbial invasion of amniotic cavity occurs in 30 to 50% of patients with premature membrane rupture. Aim: To determine the outcomes associated with microbial invasion of the amniotic cavity (MIAC) in patients with preterm premature rupture of membrane (pPROM). Patients and methods: One hundred thirty four patients with preterm pPROM between 24 and 34 weeks of pregnancy, without clinical infection or labor, were studied. Cultures were obtained by transabdominal amniocentesis from the amniotic fluid and the lower genital tract. Four groups of MIAC were observed: MIAC1: due to S. agalactiae, F. nucleatum or H. influenzae as only etiologic agents, MIAC2: due to other bacteria, alone or mixed, MIAC3: due to U. urealyticum as only etiologic agent, MIAC0: No MIAC and no infection of the lower genital tract. Study patients received antibiotics and were managed expectantly until 35 weeks unless clinical chorioamnionitis developed or an amniotic fluid culture returned positive for S. agalactiae, F. nucleatum or H. influenzae. Results: Ninety six patients were enrolled: MIAC1 (n=11), MIAC2 (n=30), MIAC3 (n=19) and MIAC0 (n=36). Clinical chorioamnionitis was more common in patients with MIAC1 than those with MIAC3 (p<0.01) and those without infection (p<0.001). The admission to delivery interval was shorter in patients with MIAC1 (2.8 days) than those with MIAC3 (10.1 days, p<0.05) and those without infection (18 days, p<0.001). Delivery within 48 h and within 7 days of admission were also more frequent in patients with MIAC1 than in patients with MIAC3 (p<0.05) or those without infection (p<0.001). Newborns to mothers with MIAC1 had a higher frequency of infection (36%), asphyxia (36%), admission to neonatal ICU (100%) and death (46%) than those of mothers with MIAC3 and those without infection. Birth weight was also significantly lower. Histological chorioamnionitis was more common in patients with MIAC1 than in patients with MIAC3 and those without infection. The rate of funisitis was higher in patients with MIAC1 than those without infection. Conclusions: In patients with preterm PROM, microbial invasion of the amniotic cavity by S. agalactiae, F. nucleatum or H. influenzae is associated with high frecuency of adverse maternal and neonatal outcomes and neonatal death (Rev Méd Chile 2005; 133: 51-61)info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.133 n.1 20052005-01-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872005000100007es10.4067/S0034-98872005000100007
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Amniotic fluid Fetal membranes premature rupture Labor complications Premature birth
spellingShingle	Amniotic fluid Fetal membranes premature rupture Labor complications Premature birth Ovalle S,Alfredo Gómez M,Ricardo Martínez T,M. Angélica Kakarieka W,Elena Fuentes G,Ariel Aspillaga M,Carlos Ferrand M,Pedro Ramírez F,Carlos Invasión microbiana de la cavidad amniótica en la rotura de membranas de pretérmino: Resultados maternoneonatales y patología placentaria según microorganismo aislado
description	Background: Microbial invasion of amniotic cavity occurs in 30 to 50% of patients with premature membrane rupture. Aim: To determine the outcomes associated with microbial invasion of the amniotic cavity (MIAC) in patients with preterm premature rupture of membrane (pPROM). Patients and methods: One hundred thirty four patients with preterm pPROM between 24 and 34 weeks of pregnancy, without clinical infection or labor, were studied. Cultures were obtained by transabdominal amniocentesis from the amniotic fluid and the lower genital tract. Four groups of MIAC were observed: MIAC1: due to S. agalactiae, F. nucleatum or H. influenzae as only etiologic agents, MIAC2: due to other bacteria, alone or mixed, MIAC3: due to U. urealyticum as only etiologic agent, MIAC0: No MIAC and no infection of the lower genital tract. Study patients received antibiotics and were managed expectantly until 35 weeks unless clinical chorioamnionitis developed or an amniotic fluid culture returned positive for S. agalactiae, F. nucleatum or H. influenzae. Results: Ninety six patients were enrolled: MIAC1 (n=11), MIAC2 (n=30), MIAC3 (n=19) and MIAC0 (n=36). Clinical chorioamnionitis was more common in patients with MIAC1 than those with MIAC3 (p<0.01) and those without infection (p<0.001). The admission to delivery interval was shorter in patients with MIAC1 (2.8 days) than those with MIAC3 (10.1 days, p<0.05) and those without infection (18 days, p<0.001). Delivery within 48 h and within 7 days of admission were also more frequent in patients with MIAC1 than in patients with MIAC3 (p<0.05) or those without infection (p<0.001). Newborns to mothers with MIAC1 had a higher frequency of infection (36%), asphyxia (36%), admission to neonatal ICU (100%) and death (46%) than those of mothers with MIAC3 and those without infection. Birth weight was also significantly lower. Histological chorioamnionitis was more common in patients with MIAC1 than in patients with MIAC3 and those without infection. The rate of funisitis was higher in patients with MIAC1 than those without infection. Conclusions: In patients with preterm PROM, microbial invasion of the amniotic cavity by S. agalactiae, F. nucleatum or H. influenzae is associated with high frecuency of adverse maternal and neonatal outcomes and neonatal death (Rev Méd Chile 2005; 133: 51-61)
author	Ovalle S,Alfredo Gómez M,Ricardo Martínez T,M. Angélica Kakarieka W,Elena Fuentes G,Ariel Aspillaga M,Carlos Ferrand M,Pedro Ramírez F,Carlos
author_facet	Ovalle S,Alfredo Gómez M,Ricardo Martínez T,M. Angélica Kakarieka W,Elena Fuentes G,Ariel Aspillaga M,Carlos Ferrand M,Pedro Ramírez F,Carlos
author_sort	Ovalle S,Alfredo
title	Invasión microbiana de la cavidad amniótica en la rotura de membranas de pretérmino: Resultados maternoneonatales y patología placentaria según microorganismo aislado
title_short	Invasión microbiana de la cavidad amniótica en la rotura de membranas de pretérmino: Resultados maternoneonatales y patología placentaria según microorganismo aislado
title_full	Invasión microbiana de la cavidad amniótica en la rotura de membranas de pretérmino: Resultados maternoneonatales y patología placentaria según microorganismo aislado
title_fullStr	Invasión microbiana de la cavidad amniótica en la rotura de membranas de pretérmino: Resultados maternoneonatales y patología placentaria según microorganismo aislado
title_full_unstemmed	Invasión microbiana de la cavidad amniótica en la rotura de membranas de pretérmino: Resultados maternoneonatales y patología placentaria según microorganismo aislado
title_sort	invasión microbiana de la cavidad amniótica en la rotura de membranas de pretérmino: resultados maternoneonatales y patología placentaria según microorganismo aislado
publisher	Sociedad Médica de Santiago
publishDate	2005
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872005000100007
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Invasión microbiana de la cavidad amniótica en la rotura de membranas de pretérmino: Resultados maternoneonatales y patología placentaria según microorganismo aislado

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