J Med Assoc Thai 2005; 88 (7):973

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Incidence of Neonatal Infection in Newborn Infants with a Maternal History of Premature Rupture of Membranes (PROM) for 18 Hours or Longer by Using Phramongkutklao Hospital Clinical Practice Guideline (CPG)
Ratanakorn W Mail, Srijariya W , Chamnanvanakij S , Saengaroon P

Background: Phramongkutklao CPG was developed for detecting infants with maternal PROM > 18 hours who had a high risk of infection.
Objective: To determine efficacy of the CPG, and risk factors of infection.
Study design: Prospective cohort study.
Material and Method: Eligible infants were categorized into group I (symptomatic), group II (chorioamnionitis) or group III (asymptomatic). Infants in group I, II and those in group III who had scores > 3 were treated with antibiotics. Infants were followed-up until 28 days of age.
Results: 104 infants were recruited into the present study. 29 of 104 (27.88%) infants had infection. Risk factors were Apgar scores < 5, PROM > 72 hours, gestational age < 34 weeks, and low birth weight. The success rate of using CPG was 98.08% and antibiotic use was reduced by 53.08%.
Conclusion: Phramongkutklao CPG on PROM is safe and cost saving. All risk factors should be included in the guideline.

Keywords: Premature rupture of membranes (PROM), Neonatal infection, Clinical practice guideline (CPG)


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