الفهرس 
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Abstract
Preterm premature rupture of membrane (PPROM) refers to the rupture of the fetal membranes before the completion of 37 weeks of gestation during pregnancy. The fetal membranes provide a mechanical barrier that protects the fetus from microbial organisms present in the uterus. Membrane rupture often happens near the end of pregnancy when the uterus contracts (during true labor). This is because the fetal membrane is composed of two layers: the amnion, which has a strong structure that can withstand pressure until the end of pregnancy, and the outer layer called the chorion. During the last stages of pregnancy, the fetal membranes experience both physical and biochemical transformations. These include an augmentation in collagenolytic activity, which refers to the breakdown of collagen, as well as apoptosis, which is the process of programmed cell death. These changes occur in order for the fetal membranes to lose their structure. The alterations compromise the integrity of fetal membranes and result in their rupture during true labor, which is characterized by uterine contractions, facilitating the delivery of the fetus. Preterm premature rupture of membranes (PPROM) is typically a pathological condition that poses a risk to both the mother and the newborn.
The major goal of this research was to determine which antibiotics were most effective against common strains of microorganisms found in the women who had preterm premature rupture of membrane by high vaginal vulture. Among pregnant women receiving care at Minia University Maternity Hospital [MUMH], the study also sought to assess the impact of antibiotic susceptibility on maternal and foetal outcomes.
This prospective study was conducted in Minia Maternity and Children university hospital, Egypt on 101 pregnant females presented with PPROM between 24- and 36-weeks’ gestation between January 2023 to December 2023.
The main results of the study revealed that:
the mean ± SD of maternal age was 27.18± 5.82, the mean ± SD of gravidity was 3.62±2.51, the mean ± SD of parity was1.88±1.78 and the mean ± SD of Gestational age was 30.86± 3.09 and 68 of patients was rural while 33 was urban, 25of patients was working while 76 was housewife.
the mean ± SD of Temperature was 37.7± 0.5, the mean ± SD of Pulse was 90.6±16.3, the mean ± SD of TLC was 10.7±3.6 and in CRP 65 patient was negative while 36 was positive.
there was 29(28.7%) patient had E. coli, 9(8.9%) patient had coagulase negative staphylococcus, 23(22.8%) patient had Staphylococcus aureus, 26(25.7%) patients had Klebsiella pneumonia, 16(15.8%) patients had acinetobacter baumannii, 1(0.99%) patients had Enterococcus spp, 7(6.9%) patients had non-hemolytic streptococci and 5(4.95%) patients had no growth after 48 h incuation.
40(39.6%) Patient had Gram positive bacteria while 71(70.3%) had Gram negative bacteria.
that there was 76 (75.2%) patients had No growth urine culture, 14(13.9%) had E. coli, 3(2.97%) had group B streptococcus, 3(2.97%) had k. pneumonia and 5(4.96%) had s. aureus (MRSA) while culture pus mean was 4.84±4.21.
According to Antimicrobial susceptibility of isolated bacteria, the most of patients had sensitivity to gentamicin in both high vaginal swab and urine culture.
According to duration of PPROM between the studied groups the mean of duration of PPROM was 9.7 with SD 16.8.
According to Maternal outcome between the studied groups there was 27.7% had Subclinical chorioamnionitis, 5.9% had Placental separation, 5.94% had Clinical chorioamnionitis, 2.97% had Puerperal sepsis, 4.95% had Wound infection, 0.9% had Cord prolapse and in maternal morbidity 23.8% was yes while 75.2% was no.
According to Neonatal outcomes between the studied groups there was 67(66.3%) patients transformed to NICU while the others not, there was 53(52.5%) patients have RDS and others not, there was 27(26.7%) patients have Neonatal Jaundice and others not, there was 17(16.8%) patients have Neonatal sepsis and others not, there was 5(5%) patients have IVH and others not, there was 3(3%) patients have Congenital anomalies and others not, there was 27(26.7%) patients have Neonatal death and others not and the mean birth weight was 2013.96 with SD 380.96.