The bacteriological assessment of urine in patients with premature rupture of membranes


  • Kumer Tanshen Dhaka Medical College Hospital, Dhaka, Bangladesh
  • Panchami Goshwami 300 Bedded Hospital, Narayanganj, Bangladesh
  • Shanta Tribedi Dhaka Medical College Hospital, Dhaka, Bangladesh
  • Sarvin Haider Medinova Diagnostic Center, Narayanganj, Bangladesh



Urinary tract infections, PROM, E. coli, Chorioamnionitis, Obstetrical complications


Background: PROM occurs in 10% of all pregnancies. Urinary tract infections (UTIs) are the most common bacterial infections in pregnancy. Asymptomatic bacteriuria (ASB), occurring in 2-11% of pregnancies, is a significant predisposition to the development of pyelonephritis and UTI, which are associated with obstetrical complications, such as preterm labor and low birth weight infants.

Methods: This study was carried out at the Department of Obstetrics and Gynaecology, Mymensingh Medical College Hospital, Mymensingh, Bangladesh, over a period of 6 Months from July 2011 to December 2011.

Results: A total of 100 patients of PROM were included in this study within this period. The mean age was 27.10±4.49 (SD) years in patients’ of PROM, and the prevalence of gestational week was found at 26 (26%) at 30 weeks, 20 (20%) at 32 weeks, 22 (22%) at 33 weeks, 28 (28%) were at 34 weeks, and 4 (4%) were at 39 weeks. Most of the cases were no growth (84%), E. coli (12%), Streptococcus (2%), Candida (1%), and anaerobs (1%). 52% were preterm, and 42% were term delivery. 40% developed chorioamnionitis, 10% developed puerperal sepsis, and 8% developed DIC, and this prospective observational study revealed that 16% of cases of PROM patients’ were associated with urinary tract infection.

Conclusions: This study was undertaken to determine the bacteriological assessment of urine of patient’s with premature rupture of membrane. It is found that 16% of patients’ with PROM have urinary tract infection with E. coli, Group B streptococcus, anaerobs, and candida organisms.


Deering SH, Patel N, Spong CY, Pezzullo JC, Ghidini A. Fetal growth after preterm premature rupture of membranes: is it related to amniotic fluid volume? J Matern Fetal Neonatal Med. 2007;20(5):397-400.

Ameye L, De Brabanter J, K Suykens J, Cadron I, Devlieger R, Timmerman D, Spitz B, Van Huffel S. Predictive models for long term survival after premature rupture of membranes. Conf Proc IEEE Eng Med Biol Soc. 2005;2005:4622-5.

Esim E, Turan C, Unal O, Dansuk R, Cengizglu B. Diagnosis of premature rupture of membranes by identification of beta-HCG in vaginal washing fluid. Eur J Obstet Gynecol Reprod Biol. 2003;107(1):37-40.

Hannah ME, Ohlsson A, Farine D, Hewson SA, Hodnett ED, Myhr TL, et al. Induction of labor compared with expectant management for prelabor rupture of the membranes at term. TERMPROM Study Group. N Engl J Med. 1996;334(16):1005-10.

Schucker JL, Mercer BM. Midtrimester premature rupture of the membranes. Semin Perinatol. 1996;20(5):389-400.

Niebela JCV. Prevalance of Cervico-vaginal infection by Chlamydia trachomatis, Mycoplasma hominis, Ureaplasma urealyticum and and Beta- hemolytic Streptococcus B in Pregnant women. Reproductive Med Reproduct Biol. Edited by Aldo Campana. 2008.

Delzell JE, Lefevre ML. Urinary tract infections during pregnancy. Am Fam Physician. 2000;61(3):713-21.

Harris RE, Gilstrap LC. Cystitis during pregnancy: a distinct clinical entity. Obstet Gynecol. 1981;57(5):578-80.

Hooton TM. The epidemiology of urinary tract infection and the concept of significant bacteriuria. Infection. 1990;18(2):S40-3.

Hooton TM. The epidemiology of urinary tract infection and the concept of significant bacteriuria. Infection. 1990;18(2):S40-3.

Alexander JM, Mercer BM, Miodovnik M, Thurnau GR, Goldenberg RL, Das AF, et al. The impact of digital cervical examination on expectantly managed preterm rupture of membranes. Am J Obstet Gynecol. 2000;183(4):1003-7.

Schutte MF, Treffers PE, Kloosterman GJ, Soepatmi S. Management of premature rupture of membranes: the risk of vaginal examination to the infant. Am J Obstet Gynecol. 1983;146(4):395-400.

Kilpatrick SJ, Patil R, Connell J, Nichols J, Studee L. Risk factors for previable premature rupture of membranes or advanced cervical dilation: a case control study. Am J Obstet Gynecol. 2006;194(4):1168-74.

Tanir HM, Sener T, Artan S, Kaytaz B, Sahin-Mutlu F, Ozen ME. Programmed cell death (apoptosis) in placentas from normal pregnancy and pregnancy complicated by term (t) and preterm (p) premature rupture of membranes (PROM). Arch Gynecol Obstet. 2005;273(2):98-103.

Dudley J, Malcolm G, Ellwood D. Amniocentesis in the management of preterm premature rupture of the membranes. Aust N Z J Obstet Gynaecol. 1991;31(4):331-6.

Bengtson JM, VanMarter LJ, Barss VA, Greene MF, Tuomala RE, Epstein MF. Pregnancy outcome after premature rupture of the membranes at or before 26 weeks' gestation. Obstet Gynecol. 1989;73(6):921-7.

Jennifer D, Michael P. Pregnancy Outcome Following Preterm Premature Rupture the Membranes at Less Than 26 Weeks’ Gestation. Aust NZ Obstet Gynaecol 1989;73:921-7.

Miller HC, Jekel JF. Epidemiology of spontaneous premature rupture of membranes: factors in pre-term births. Yale J Biol Med. 1989;62(3):241-51.

Ziaei S, Sadrkhanlu M, Moeini A, Faghihzadeh S. Effect of bacterial vaginosis on premature rupture of membranes and related complications in pregnant women with a gestational age of 37-42 weeks. Gynecol Obstet Invest. 2006;61(3):135-8.

Schultz R, Read AW, Straton JA, Stanley FJ, Morich P. Genitourinary tract infections in pregnancy and low birth weight: case-control study in Australian aboriginal women. BMJ. 1991;303(6814):1369-73.






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