Prelabour rupture of membranes at term (PROM)
Conditions
Interventions
Consenting participants will be randomized into two groups. The intervention group will receive intravenous cefuroxime 750mg 8 hrly for 24 hrs followed by oral cefuroxime 500 mg 12 hourly for 48 hrs
Sponsors
Professorial Unit (Gynaecology & Obstetrics)
Eligibility
Inclusion criteria
Inclusion criteria: 1. Pregnant mothers with confirmed gestational age more than 37 & less than 42 weeks. 2. Singleton pregnancies with cephalic presentation 3. Ruptured membranes for less than 12hrs 4. Absence of uterine contractions on admission
Exclusion criteria
Exclusion criteria: Mothers with following complications, on admission will be excluded from the study 1. Foetal death or anomaly 2. Placenta praevia 3. Placental abruption 4. Chorioamnionitis 5. Indicated for a caesarean section on admission 6. Allergic to Cefuroxime, other cephalosporins or to penicillins 7. Contraindicated for the use of oxytocin
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Maternal & foetal 1.Chorioamnionitis: Diagnosed according to the Southern Australian Perinatal Practice Guidelines a. Maternal pyrexia (>38c) & at least two of following b. Maternal tachycardia > 100 bpm c. Foetal tachycardia >160 bpm d. Uterine tenderness e. Offensive vaginal discharge f. CRP >40 mg/L g. Increased WBC count (>15 x 109/L ) 2. Postpartum endometritis Diagnosed by pyrexia >38oC, after 24 hours of delivery in the absence of other maternal causes, with one of the following a. Uterine tenderness b. WBC count >15 x 109/L, c. CRP >20 mg/L. Post-partum sepsis is diagnosed by fever >38oC with positive blood culture. 3. Neonatal out comes Neonatal sepsis:Diagnosed by raised CRP (>20 mg/L), WBC 30 x 109/L or positive blood cultures with minimum of one of the following clinical signs: hyperthermia/ hypothermia, lethargy, poor feeding, tachypnea, vomiting or abdominal bloating. [1a. Maternal pyrexia: 8 hourly for 72 hours after delivery 1b. Maternal pulse and other factors measured if there is pyrexia 1c. Foetal heart rate: every 15 minutes using hand held doppler, until delivery 2a. Maternal pyrexia and uterine tenderness assessed every 8 hours for 72 hours. 2b. Other investigations to be done if maternal temperature >38oC 3. Neonatal outcomes be measured 8 hourly for 72 hours] | — |
Secondary
| Measure | Time frame |
|---|---|
| None [None] | — |
Countries
Sri Lanka
Contacts
Public ContactDr. S N M Punsiri Kamal Gunathilaka,
Registrar (Gynaecology & Obstetrics),
Outcome results
None listed