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Antimicrobial therapy in preterm premature rupture of membranes: results of a prospective, double-blind, placebo-controlled trial of erythromycin

Article Abstract:

Premature rupture of membranes (PROM) occurs in up to 2 percent of pregnancies and causes up to 40 percent of preterm births, the leading cause of death in the perinatal period (late pregnancy through early infancy). The best treatment for PROM is unknown. Major risks accompany premature births, but infections are also likely in cases where labor does not ensue immediately. The chance of survival without handicap is estimated to increase by 3 percent each day that labor is forestalled. Infection may contribute to PROM and may also develop after membrane rupture and can hasten onset of labor. The outcome of treating 154 cases of PROM with erythromycin was evaluated. Among women whose pregnancies that continued for at least 10 days after PROM, duration of time between PROM and delivery was significantly longer in those treated with erythromycin. In addition, women for whom PROM occurred between 28 and 32 weeks of gestation also continued pregnancies significantly longer. Surviving newborns of women treated with erythromycin required fewer days of higher level nursery care. No serious side effects occurred. The study suggests that antibiotic therapy may prolong pregnancy in some women with PROM, allowing further fetal maturation. (Consumer Summary produced by Reliance Medical Information, Inc.)

Prevention, Drug therapy, Erythromycin

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Prevention of premature birth by screening and treatment for common genital tract infections: results of a prospective controlled evaluation

Article Abstract:

Pregnant women with untreated common genital tract infections appear to experience increased pregnancy loss, premature births, and premature rupture of amniotic membranes. Of 1,138 pregnant women enrolled in a study, about one-third had bacterial vaginosis and about 10% had trichomoniasis. Bacterial vaginosis was associated with higher risk of prematurity, however, the incidence of prematurity was reduced by 50% after using oral clindamycin to treat the genital infection. Trichomoniasis infections and combined infections also carried higher risks of premature birth, but the incidence became lower with treatment. Increased vaginal fluid levels containing interleukins and certain enzymes may contribute to premature rupture of membranes and preterm labor. Pregnant women should be screened for reproductive tract infections and treated with systemic medications recommended by the Centers for Disease Control and Prevention.

Causes of, Complications and side effects, Pregnant women, Vaginosis, Premature birth

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