Different Management Strategies for Term Newborns Delivered with Premature rupture of membranes: Randomized Controlled Trial

Background: Premature rupture of membranes (PROM) is a leading cause of neonatal morbidity and mortality. Aim: To compare the outcomes of prophylactic versus selective antibiotics in term newborns born after PROM > 18 hours in terms of neonatal sepsis and resistance of neonatal. Study design: Randomized controlled trial. Methodology: This study enrolled (n=120) asymptomatic term (37(+) weeks) babies of either gender with PROM > 18 hours after ethical review committee's (ERC) approval. This study held at DHQ Hospital, Rawalpindi-Pakistan in 2019. Data was collected through a structured proforma with informed consent. Data was analyzed by SPSS, v-20. The study outcomes were neonatal sepsis and resistant neonatal flora. Chi-square test was applied with p <= 0.05 taken as significant. Results: The neonatal sepsis was diagnosed in 8 (13.3%) and 9(15%) babies in the prophylactic treatment group and the selective treatment group, respectively having statistically insignificant difference (p>0.05). Likewise, resistant neonatal flora between both groups showed statistically insignificant difference (p>0.05). Conclusion: We concluded that there was insignificant difference in terms of rates of neonatal sepsis and resistant neonatal flora between two treatment groups. However, there is a need to conduct large sample size, multicentre studies to validate these results before making recommendations for routine treatment of full term babies with PROM >18 hours in our clinical settings.