Vaginal flora in preterm premature rupture of membranes: A case-control study from a tertiary care centre in South India
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background: Preterm premature rupture of membranes (PPROM) is a major antecedent of preterm birth, commonly driven by ascending genital tract infection. Locally relevant South Indian microbiological data remain limited. We characterised vaginal flora in women with PPROM versus gestation-matched controls and evaluated associated maternal and neonatal outcomes.Materials and Methods: In this case-control study at a tertiary care centre in South India (18 months), 71 women with PPROM (28+0–36+6 weeks) were compared with 71 gestation-matched antenatal controls. High vaginal swabs were cultured aerobically with standard biochemical identification and antibiotic susceptibility testing. Maternal and neonatal outcomes were recorded until discharge and analysed using chi-square, Fisher's exact test, independent t-test, and multivariate logistic regression.Results: Baseline characteristics were comparable between groups. Culture positivity was higher in PPROM (47.9% vs 29.6%; p=0.038), with Streptococcus spp. (8.5%), Escherichia coli (8.5%), methicillin-resistant Staphylococcus aureus (MRSA, 5.6%), and Enterococcus spp. (5.6%) predominating, against predominantly culture-negative vaginal flora among controls (70.4%). Escherichia coli isolates were uniformly resistant to cephalosporins but remained susceptible to beta-lactam/beta-lactamase-inhibitor combinations and aminoglycosides; all Gram-positive isolates were susceptible to linezolid, vancomycin, and teicoplanin. Prior urinary tract infection (UTI)/vaginal infection was more common in PPROM (25.4% vs 5.6%; p=0.002). Neonatal outcomes were markedly worse in PPROM: low birth weight (52.1% vs 28.2%; p=0.006), neonatal intensive care unit (NICU) admission (49.3% vs 15.5%; p
Language: English
Subfield: Obstetrics and Gynecology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7220373899