Am J Perinatol 1997; 14(8): 483-486
DOI: 10.1055/s-2007-994185
ORIGINAL ARTICLE

© 1997 by Thieme Medical Publishers, Inc.

Prolonged Rupture of Membranes in the Term Newborn

Sharon E. Marlowe1 , Jeffrey Greenwald2 , Mujahid Anwar3 , Mark Hiatt3 , Thomas Hegyi3
  • 1Sentare Leigh Hospital, Norfork, Virginia
  • 2Division of Neonatology, Department of Pediatrics, Portsmouth Naval Hospital, Portsmouth, Virginia
  • 3Division of Neonatology, Department of Pediatrics, UMDNJ-Robert Wood Johnson Medical School, St. Peter's Medical Center, New Brunswick, New Jersey
Further Information

Publication History

Publication Date:
04 March 2008 (online)

ABSTRACT

Of 8791 consecutive newborns, we studied 205 (2.3%) women with a history of prolonged rupture of membranes (PROM) greater than 24 hr to assess the incidence of infection, to identify the rate of clinical symptoms, and to examine the use of the white blood count (WBC) and neutrophil values as screening tools to predict infection. Blood culture and complete blood counts (CBC) were obtained in 175 (85%). Fifteen (8.2%) had positive blood cultures including group B streptococcus, streptococcus viridans, streptococcus pneumoniae, staphlococcus epidermidis, and staphlo-coccus aureus. In the remaining 8586 infants born to mothers without PROM, 10 had positive blood cultures for an incidence of 0.1%. In the PROM group, the six who manifested clinical symptoms had abnormal CBCs; abnormal white blood count (2), abnormal neutrophil count (5), high band/metatamyelocyte count (4), and increased immature to total neutrophil ratio (4). Of the nine asymptomatic infants, seven (78%) had abnormal CBCs, five (56%) with a high WBC, five (56%) had a high neutrophil count, two (22%) had a high band/metatamyelocyte count, and one a high immature to total neutrophil ratio. CBC values were obtained from infants with PROM and negative blood cultures. Five of these 15 controls had an abnormal CBC. In the term newborn, PROM is associated with significantly increased incidence of positive blood cultures. The sensitivity of the CBC was 86% and specificity 66%. In view of this data a conservative clinical approach utilizing blood cultures and CBC evaluations in the management of PROM is warranted.

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