The Outcomes of Ampicillin Plus Azithromycin to Prolong Latency Period in Preterm Premature Rupture of Membranes between 24 and 33+6 weeks of gestation in King Chulalongkorn Memorial Hospital

• Main Authors: Nannapat Sinrat, Surasith Chaithongwongwatthana
• Format: Article
• Language: English
• Published: The Royal Thai College of Obstetricians and Gynaecologists 2020-07-01
• Series: Thai Journal of Obstetrics and Gynaecology
• Subjects: antibiotic; azithromycin; premature rupture of membrane; prolong latency period
• Online Access: https://he02.tci-thaijo.org/index.php/tjog/article/download/158200/165045/

Objectives: To determine the success rate of ampicillin plus azithromycin to prolong the latency period in cases with preterm premature rupture of membranes (PPROM).Materials and Methods: A retrospective descriptive study was conducted. Medical records of singleton pregnancies between 24 and 33+6 weeks of gestation who complicated with PPROM and received ampicillin and oral azithromycin to prolong the latency period at King Chulalongkorn Memorial Hospital between January 2010 and December 2016 were reviewed. Prolonged latency period more than 48 hours was defined as success. Descriptive statistics were used for data analysis. Results: Eighty eight pregnancies were included in the study with mean ± standard deviation age of 30.4 ± 5.6 years and mean gestational age of 31.3 ± 2.5 weeks. The median of latency period was 96 hours (interquartile range 60-192 hours) and 76 cases (86.4%) reached more than 48 hours of latency period. Seven women (8.0%) complicated by chorioamnionitis with 1 case of maternal sepsis. Regarding neonatal outcomes, respiratory distress syndrome (RDS) complicated in 29 neonates (33.0%) and 12 cases (13.6%) needed ventilator. Forty eight cases (54.5%) found neonatal sepsis along with 3 (3.4%) neonatal deaths.Conclusion: Antibiotic regimen including ampicillin and azithromycin was effective to prolong latency period in most women presented with PPROM. However, one-third of the neonates complicated with RDS and neonatal sepsis was found in more than half of the cases. Further study is needed to identify regimens that may improve neonatal outcomes.