[Is the mother's bacterial vaginosis with PROM a significant factor for intrauterine infection of the fetus in preterm labor before 32 weeks of gestation].

OBJECTIVE: Bacterial vaginosis of pregnant woman is an important factor of appearance of the PROM in result of intrauterine infections on every stage of pregnancy. Frequency exist of intrauterine infection evaluate from 1 to 10% pregnancies. Clinical chorio-amnionitis complicates 1-5% of term pregnancies, but nearly 25% of preterm deliveries and really increase morbidity and mortality of newborns and they are also a reason of mothers morbidity. A condition of recognition the intrauterine infections is ascertainment of infection factor risk of mother and appearance of clinic symptoms of newborns. The aim of this work was a valuation of dependence between bacterial flora taken from cervics uteri of pregnant woman with PROM who gave birth with preterm below 32 weeks and a presence of clinic and laboratory symptoms of infections and the presence of bacterial flora in blood culture of the newborns.

MATERIAL AND METHODS: 37 pregnant women at the age from 20 to 43 hospitalized in Department Perinatology ICZMP between 1999-2001 because of PROM and a threat of preterm labor at the fetal age from 24 to 32 weeks were taken by an analysis. The average time of amniotic liquid outflowing before the labor was 11.1 days +/- 8.63, average length persistence of pregnancy was 27.6 hbd +/- 1.85, average born mass was 1029 g +/- 187.5. Laboratory factors and clinics symptoms chorionamnionitis, bacteriology cultures of swabs from cervics uteri and information of the labor of pregnant women were analyzed. Diagnostics of newborns contained: making of blood cultures and skin, nose, throat, urine cultures, estimation WBC and level CRP, estimation of lungs X-ray.

RESULTS: In result of bacteriology cultures from cervics uteri of mothers gained bacteria of frequent occurrence: Staphylococcus epiderm.--27%, E. coli--19%, Streptococcus gr. B--10.8%, Enterococcus foecalis--8.1%. In result of bacteriology cultures of newborns blood gained bacteria of frequent occurrence: Staphylococcus epiderm.--13.5%, Staphylococcus haemolitycus--10.8%, Klebsiella pneumoniae--10.8%, Pseudomonas aeruginosa--8.1%. In 97.3% cases at newborns appeared inborn infections in a shape of pneumonia confirmed by X-ray. Confirmation of intrauterine infection in histopathology examination of the placenta in a shape of chorionamnionitis was shown in 25 cases, in other words in 67.5%. Positive results of pathogenic bacteriology flora cultures taken from cervics uteri was in 50% pregnant woman, however in 43% of newborns bacteriology cultures of the blood were positive. In none of the analyzed preterm labor cases with PROM bacterial flora from positive cultures taken from cervics uteri of mothers did not correlate with bacterial flora found in blood cultures of newborns.

CONCLUSIONS: On a base of analyzed values PROM of mothers with bacterial vaginosis is the important factor risk of the evolution of intrauterine infections of newborns, besides did not ascertain the dependence between the values of bacteriology cultures taken from cervics uteri of mothers and the values of bacteriology cultures of the newborns blood with clinic symptoms of intrauterine infection.