Objective: The antepartum course and short-term neonatal outcome for patients with premature rupture of membranes between 26 and 33 weeks' gestation with positive cervical cultures for group B streptococcus or Neisseria gonorrhoeae were reviewed.
Study design: A retrospective analysis of 182 patients managed expectantly over a 3-year period was done. Thirty-four patients had cervical cultures positive for group B streptococcus, 11 had positive cultures for Neisseria gonorrhoeae, and 137 had negative cultures. Prophylactic antibiotics were routinely given, and antibiotic therapy was continued in patients with positive cultures.
Results: There was no difference between groups in latent phase or maternal morbidity. The incidence of neonatal pneumonia was increased in those with positive cervical cultures (p = 0.009, odds ratio 6.9, 90% confidence interval 2.1 to 22.8), but there was no difference in neonatal sepsis, respiratory distress, or neonatal mortality.
Conclusion: These data support the conservative or expectant management of premature rupture of membranes between 26 and 33 weeks in patients with positive cervical cultures who are given prophylactic antibiotic therapy.