Evaluation of Endocervical Microbial Colonization in Premature Rupture of Membranes and Pregnancy Outcomes: A Cross-sectional Observational Study.

Objective: Premature rupture of membranes (PROMs) is one of the common causes of preterm birth which has a major contribution to maternal and fetal adverse outcomes. Infection may be contributing to premature rupture of membrane or it may be a consequence. The aim of our study was to assess the common pathogens colonizing the endocervix in women with PROM and pregnancy outcomes. Materials and methods: In this prospective observational study, seventy antenatal women with PROM after 24 weeks of gestation were studied from January 2020 to July 2021. Two swabs were taken from the endocervix. Swabs were subjected to gram staining and culture. The association of endocervical culture positivity with chorioamnionitis, mode of delivery, and neonatal outcome was evaluated. Results: In the study, 24.2% of endocervical cultures were positive. The pathogens isolated were Escherichia coli in 11.4%, Staphylococcus hemolyticus in 2.9%, budding yeast in 2.9%, 1.4% each with Klebsiella pneumoniae and Methicillin-resistant Staphylococcus aureus (MRSA). The culture was positive in 30.3% of subjects with preterm PROM and 18.9% with PROM (p = 0.40). The incidence of chorioamnionitis was higher with endocervical culture-positive cases as compared to culture-negative women (p = 0.05). There was no association of endocervical culture positivity with the neonatal intensive care unit (NICU) admission, duration of membrane rupture, and mode of delivery. Conclusion: In our study, the most common bacteria inhabiting the endocervix in PROM was E. coli. There is a definite influence of bacterial endocervical colonization on pregnancy outcomes but further studies are needed to corroborate the findings. [ABSTRACT FROM AUTHOR]