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Utility of Performing Routine Screening Tests of Infections in the Clinical Management of Preterm Labor in a Tertiary
Regina Salve R Minaldo-Rebato1, Ricardo M Manalastas1
1Philippine General Hospital, University of the Philippines Manila.
Insights
Routine infection screening in preterm labor is not cost-effective. Most cultures were negative, and urine tests were common, but didn't significantly alter management for preterm birth complications.
Area of Science:
- Obstetrics and Gynecology
- Infectious Diseases
- Neonatal Health
Background:
- Preterm birth is a leading cause of mortality in children under five.
- Identifying infections is crucial as antimicrobial treatment can delay preterm delivery.
Purpose of the Study:
- To evaluate the utility of routine infection screening tests in managing preterm labor.
- To assess the clinical value of infection screening in pregnant patients experiencing preterm labor.
Main Methods:
- A cross-sectional descriptive study was conducted.
- Data from 417 pregnant patients admitted for preterm labor (2015-2019) were reviewed.
- Medical records, inpatient charts, and admission charts were analyzed.
Main Results:
- Most patients delivered before 34 weeks gestation.
- Culture results were predominantly negative; urine tests were common screening methods.
- Asymptomatic bacteriuria was found in 10% of patients, treated with antibiotics, with most delivering within 48 hours.
Conclusions:
- Routine culture use in preterm labor assessment is costly and offers limited clinical benefit.
- Current screening practices may not be effective in guiding management for preterm labor.
Objective:
Preterm birth is a major cause of complications leading to death of children under 5 years old. Infections are important to be identified because antimicrobial treatment may prevent or delay progression to preterm delivery. This study determined if routine screening tests of infections are useful in the clinical management of preterm labor.
Methods:
A cross-sectional (descriptive) study was done involving 417 pregnant patients who had preterm labor and was subsequently admitted from 2015 to 2019 at a tertiary hospital in the Philippines, using review of past medical records, inpatient charts, and admission charts.
Results:
Majority of the patients delivered at less than 34 weeks, most of the culture results turned out negative, and urine tests were more commonly employed as screening tests for preterm labor. The endocervical and rectovaginal swab studies had no significant growths. Asymptomatic bacteriuria was diagnosed in 1 out of 10 patients and they were subsequently started on antibiotic treatment. Majority of the patients who were given antibiotics delivered within 48 hours from admission.
Conclusion:
The routine use of cultures in the assessment of preterm labor is costly and is unlikely to be helpful in the clinical management of patients in preterm labor.
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