COMPARATIVE STUDY TO ASSESS VAGINAL MICROBIOME IN WOMEN WITH TERM, THREATENED PRETERM, PRETERM LABOUR, PPROM, PROM, AND ITS EFFECT ON PREGNANCY OUTCOME

Abstract

Aims & Objective: To compare vaginal microbiome, maternal and neonatal outcome along with selection of suitable antibiotic therapy.

Materials & Methods: The present study was conducted on women (n=230) having gestational age above 28 weeks with complaints of rupture of chrioamniotic membrane. These selected women were further divided into PROM (n=45), Preterm (n=50), PROM (n=45), Term (n=45) and Threatened preterm (n=45) based on further history and clinical observations antibiotic sensitivity test.

Results: Mean BMI in PPROM group was 22.99?3.81kg/m², in preterm group it was 22.85?2.76, in PROM group it was 22.68?3.12, in term group it was 23.12?2.74 and in threatened preterm group mean BMI was 23.07?2.68kg/m². Out of 194 culture positive cases, majority of patients (n=83; 36.1%) have grown E. coli. Forty two patients have grown Candida species, Fifty one patients grown COPS species, five patients gown Klebseilla species. Only 62 babies stayed in NICU and out of them 18, 20, 5, 3 and 16 patients belonged to PPROM, preterm PROM, term and threatened preterm group respectively (p<0.001). Seventeen babies had perinatal asphyxia, only 62 babies stayed in NICU, Babies of 79 patients had abnormal APGAR score at 1 minute At APGAR score 5 minutes, babies of 36 patients had their APGAR score abnormal.

Conclusion: Most common vaginal microbiome grown on high vaginal swab in PPROM, preterm, PROM, threatened preterm is E. coli. So most common antibiotic sensitive to E. coli is cefotaxime, ceftriaxone, clindamycin, amoxycillin and cefepime. Most common vaginal microbiome in term labour is candida species so most common antibiotic sensitive to that is clotrimazole. 

Keywords: PROM, PPROM, Preterm, Threatened Preterm.