[Bacteriological and clinical studies of premature rupture of the membranes]

Cases of premature rupture of the membranes (PROM) were subjected to bacteriological examination of lower genital organs and their clinical courses were analyzed. The results obtained were summarized below. From lower genital organs of cases examined at the 24th-36th week of pregnancy, Gram-positive or Gram-negative aerobes were detected at a high rate in both the group without PROM (-) and the group with PROM (+). From patients in the group with PROM + chorioamnionitis (CAM) anaerobes as well as aerobes were detected at especially high rates. Many patients with PROM (+CAM) were administered with penicillin-antibiotics orally or parenterally. Clinical analysis showed effectiveness of these antibiotics which were especially effective when administered intravenously. The oral administration produced inferior results to the injection judging from clinical results. Patients with PROM and infection during the puerperal period were examined. They were found to include 15 cases of intrauterine infection and 6 cases of puerperal fever. Patients who started showing infectious symptoms at a later time than 8 hours after the onset of PROM tended to have a higher frequencies of infections. The rate of occurrence of cases requiring cesarean section was higher in this group than in the group where infectious symptoms started within 8 hours after PROM.