Association of Urinary Tract Infection with Premature Rupture of Membrane

Background: Premature rupture of membrane (PROM) and preterm PROM (PPROM) are closely related terms which are the major cause of maternal and fetal mortality and morbidity. PROM occurs 10% of all pregnancies. Urinary tract infections (UTI) are the most common bacterial infections of pregnancy. Objective: To find out the association of urinary tract infection with PROM among hospital admitted patients. Methods: This prospective observational study was carried out at Department of Gynecology and Obstetrics, Combined Military Hospital (CMH), Dhaka, Bangladesh, A total of 100 patients of PROM were included following selection criteria. Their urine culture was done. Maternal and fetal out comes were recorded accordingly. Results: Mean(±SD) age of the study women was 27.10±4.49 years. The prevalence of PROM was highest at 34 weeks of gestational age (28%), followed by 39 weeks (26%), 33 weeks (22%), 32 weeks (20%) and 30 weeks (4%). Among total study participants, 74% were preterm PROM and 26% were term PROM. Out of 100 PROM women 16 patients developed UTI. Most of the cases of UTI were showed no growth of organisms on urine culture (84%), while 12% urine sample showed growth of Escherichia Coli (E. Coli), followed by Streptococcus (2%), Candida (1%), Anaerobes (1%). The association between PROM types and UTI occurrence was statistically significant (p= 0.001). Among the study women, 6% developed puerperal sepsis, 5% developed chorioamnionitis and 2% developed disseminated intravascular coagulation (DIC). Regarding fetal outcomes; 85% were live birth, 15% were still birth; of them, 59% were premature baby, 55% had birth weight less than 2.5 kg and APGAR score at 5 minutes of 80% babies was <7. Conclusion: This study revealed that prevalence of UTI in PROM is 16%. Advance gestational age is strongly associated with a higher risk of UTI in PROM patients. Puerperal sepsis, chorioamnionitis and DIC were the maternal complications; while still birth, prematurity, low birth w