ASSOCIATION BETWEEN CERVICAL COLONIZATION BY GENITAL MYCOPLASMAS AND PRETERM PREMATURE RUPTURE OF FOETAL MEMBRANES

ASSOCIATION BETWEEN CERVICAL COLONIZATION BY GENITAL MYCOPLASMAS AND PRETERM PREMATURE RUPTURE OF FOETAL MEMBRANES

Abstract

Introduction: Preterm premature rupture of amniotic membranes (pPROM) occurs in 0.7-3.5% of all pregnancies across the world, and is responsible for approximately one third of all preterm births. It is the leading identifiable cause of preterm delivery. Cervical colonization by genital mycoplasmas has been associated with pPROM, especially in relation to adverse pregnancy outcomes.
Aim: To determine the proportion of women with pPROM with cervical colonization by UreaplasmaUrealyticum and Mycoplasma Hominis, the antibiotic sensitivity pattern and associated risk factors.
Methods: A prospective case control study in Ahmadu Bello University Teaching Hospital, Zaria. Eighty pregnant women were recruited into 2 equal groups of those with and without pPROM, and matched for age, parity and gestational age. Participants were recruited by convenient sampling technique, and each hada sterile speculum examination and endocervical swab taken. Analysis was with SPSS version 20.
Results: Ureaplasmaurealyticum isolation was 55% and 22.5% among cases and controls respectively while Mycoplasma hominis was 9% and 2.5% respectively. There was a statistically significant difference in positive cultures generally, and U. urealyticum between the study and controls groups. There was a positive association between M. hominis and pPROM, though not statistically significant. Both isolates were most sensitive to macrolides. Ureaplasmaurealyticum and M. hominis were most resistant to tetracyclines and quinolones respectively. Previous history of PROM, previous preterm birth and urinary tract infection significantly increased the risk of pPROM. However, only previous history of PROM was an independent risk factor.
Conclusion: There is evidence of a strong positive association between genital mycoplasma colonization and pPROM, with the effect of U. urealyticum significantly higher than that of M. hominis.
Recommendations: Antibiotic treatment of pPROM should be based on sensitivity reports of the geographical region, and counselling on the risk of recurrence in subsequent pregnancies is
essential.

ASSOCIATION BETWEEN CERVICAL COLONIZATION BY GENITAL MYCOPLASMAS AND PRETERM PREMATURE RUPTURE OF FOETAL MEMBRANES

Sharing is caring!