SUMMARY AND CONCLUSIONNeonatal sepsis is one of the major causes of morbidity and mortality in newborn infants. Clinical diagnosis is not easy because symptoms and signs are not specific and dramatic. Laboratory indicators, such as complete blood count, ratio of immature to total neutrophils and C-reactive protein (CRP) do not have high sensitivity especially if measured early in the course of sepsis.Since the outcome and prognosis depend on early and efficient antibiotic therapy, there is a need for sensitive and specific indicators for sepsis at the stage of the disease.Blood culture was the most acceptable diagnostic tool for sepsis but its report is not available before 48-72 hours.Deterioration of clinical conditions may occur very rapidly before blood culture results are available. So we should try to put strategy for early management of neonatal septicemia before appearance of blood culture results.This study was conducted on: 100 neonates diagnosed as septicemia based on clinical picture and positive blood culture, these septicemic neonates were divided into two main groups:Group I - Full term group: 50 neonates, 29 male and 21 female.Group II - preterm group: 50 neonates 32 male and 18 female.All neonates were subjected to the following:- Full Clinical history taking.- Laboratory investigations include:• CBC• CRP• Band cells• Blood culture and sensitivity tests• CSF for suspected cases of meningitis- X-ray for cases of respiratory distress.The result of our study revealed the following:- The clinical findings were variable and the most frequent clinical findings was weak reflexes with no statistical significance difference between two groups.- The most frequent maternal risk factor was PROM and low birth weight as regard neonatal risk factors in two main groups.- TLC show significant elevation in most cases with significant neutrphilia and show statistically significant difference between two main groups.- Band cells was increased in all cases .- HB% was significantly reduced in most cases.- Platelet show significant thrombocytopenia in some cases.- CRP was elevated in all cases.- As regarding blood culture the commonest organism in all cases was Klebsiella (29%), in preterm group the commonest organism was staph-aureus (36%) but in full term group was Klebsiella (32%). In early onset sepsis the most common organism was Klebsiella (30%) but in late onset sepsis was staph-aureus and Klebsiella in equal percentage.- As regard antibiotics sensitivity the most sensitive antibiotics to all isolated bacteria were impienam and amikacin, for both gram -ve, and gram positive species.We conclude that bacteriological profile of neonatal septicemia and their antibiotics sensitivities can easily recognized but its results not available before 48-72 hours. Also this bacteriological profile was different even in the same NICU in different times in the year.SUMMARY AND CONCLUSIONNeonatal sepsis is one of the major causes of morbidity and mortality in newborn infants. Clinical diagnosis is not easy because symptoms and signs are not specific and dramatic. Laboratory indicators, such as complete blood count, ratio of immature to total neutrophils and C-reactive protein (CRP) do not have high sensitivity especially if measured early in the course of sepsis.Since the outcome and prognosis depend on early and efficient antibiotic therapy, there is a need for sensitive and specific indicators for sepsis at the stage of the disease.Blood culture was the most acceptable diagnostic tool for sepsis but its report is not available before 48-72 hours.Deterioration of clinical conditions may occur very rapidly before blood culture results are available. So we should try to put strategy for early management of neonatal septicemia before appearance of blood culture results.This study was conducted on: 100 neonates diagnosed as septicemia based on clinical picture and positive blood culture, these septicemic neonates were divided into two main groups:Group I - Full term group: 50 neonates, 29 male and 21 female.Group II - preterm group: 50 neonates 32 male and 18 female.All neonates were subjected to the following:- Full Clinical history taking.- Laboratory investigations include:• CBC• CRP• Band cells• Blood culture and sensitivity tests• CSF for suspected cases of meningitis- X-ray for cases of respiratory distress.The result of our study revealed the following:- The clinical findings were variable and the most frequent clinical findings was weak reflexes with no statistical significance difference between two groups.- The most frequent maternal risk factor was PROM and low birth weight as regard neonatal risk factors in two main groups.- TLC show significant elevation in most cases with significant neutrphilia and show statistically significant difference between two main groups.- Band cells was increased in all cases .- HB% was significantly reduced in most cases.- Platelet show significant thrombocytopenia in some cases.- CRP was elevated in all cases.- As regarding blood culture the commonest organism in all cases was Klebsiella (29%), in preterm group the commonest organism was staph-aureus (36%) but in full term group was Klebsiella (32%). In early onset sepsis the most common organism was Klebsiella (30%) but in late onset sepsis was staph-aureus and Klebsiella in equal percentage.- As regard antibiotics sensitivity the most sensitive antibiotics to all isolated bacteria were impienam and amikacin, for both gram -ve, and gram positive species.We conclude that bacteriological profile of neonatal septicemia and their antibiotics sensitivities can easily recognized but its results not available before 48-72 hours. Also this bacteriological profile was different even in the same NICU in different times in the year.SUMMARY AND CONCLUSIONNeonatal sepsis is one of the major causes of morbidity and mortality in newborn infants. Clinical diagnosis is not easy because symptoms and signs are not specific and dramatic. Laboratory indicators, such as complete blood count, ratio of immature to total neutrophils and C-reactive protein (CRP) do not have high sensitivity especially if measured early in the course of sepsis.Since the outcome and prognosis depend on early and efficient antibiotic therapy, there is a need for sensitive and specific indicators for sepsis at the stage of the disease.Blood culture was the most acceptable diagnostic tool for sepsis but its report is not available before 48-72 hours.Regarding neonatal outcome of studied groups, patients with a negative amniotic fluid culture but positive PCR (group 2) had a significantly higher rate of adverse outcome including low gestational age at birth, low birth weight, and significant neonatal morbidity than those with a negative amniotic fluid culture and negative PCR (group 1). However, no differences were found between patients with a negative culture but positive PCR (group 2) and those with a positive amniotic fluid culture regardless the results of PCR (group 3).SUMMARYPreterm premature rupture of membrane occurs in 3% of pregnancies and is responsible for approximately one-third of all preterm births.Preterm PROM is an important cause of perinatal morbidity and mortality.Recent studies suggest an association between Intrauterine infection and both preterm delivery and morbidity of preterm infant. U. Urealyticum is the microorganism most frequently isolated from amniotic fluid of women with preterm labour and PROM.U. urealyticum has been implicated in the genesis of clinical chorioamnioitis, puerperal endometritis, neonatal sepsis and bronchopulmonary dysplasia (chronic lung disease).U. urealyticum isolation in clinical specimens remains a challenge, microbial culture for this organism require special culture conditions and results are generally not availably in time for clinical management decisions.Recently PCR has became an optimal method for the rapid detection of U. urealyticum in clinical specimen.The aim of our study was to determine the frequency and clinical significance for the detection of U. urealyticum in patients with preterm premature rupture of membranes.Our study included 100 patients with preterm premature rupture of membranes with gestational age less than 35 weeks and singleton gestation.Patients participated in our study underwent full history taking and clinical examination.Amniotic fluid was collected by transabdominal amniocentesis guided by ultrasonography and was immediately examined for WBC,s count and sent for microbiologic culture. An aliquot of fluid was stored at -70°C for PCR examination.According to the results of amniotic fluid cultures and PCR for U. urealyticum patients divided into 3 groups:o Group 1: (n.=59) Those with a negative amniotic fluid culture and a negative PCR assay.o Group 2 (n.=15): Those with a negative amniotic fluid culture but a positive PCR for Ureaplasma urealyticum.o Group 3 (n.=26): Those with a positive amniotic fluid culture for microorganisms regardless of the results of PCR.Regarding maternal age of the studied groups, There was no significant differences in the mean age at amniocentesis among the 3 group of patients.The difference in the gestational age at amniocentesis among the 3 groups of patients was not statistically significant, however patients with a positive amniotic fluid culture regardless PCR (group 3) showed the lowest mean gestational age at amniocentesis among the 3 studied groups.Patients with a negative amniotic fluid culture but a positive PCR (group 2) had a significantly higher amniotic fluid white blood cell count than those with a negative amniotic fluid culture and a negative PCR. However, there was no significant difference in the amniotic fluid white blood cell count between patients with a negative amniotic fluid culture but positive PCR and those with a positive amniotic fluid culture.The three studied groups regarding clinical chorioamnionitis revealed no statistically significant difference.Regarding neonatal outcome of studied groups, patients with a negative amniotic fluid culture but positive PCR (group 2) had a significantly higher rate of adverse outcome including low gestational age at birth, low birth weight, and significant neonatal morbidity than those with a negative amniotic fluid culture and negative PCR (group 1). However, no differences were found between patients with a negative culture but positive PCR (group 2) and those with a positive amniotic fluid culture regardless the results of PCR (group 3).SUMMARYPreterm premature rupture of membrane occurs in 3% of pregnancies and is responsible for approximately one-third of all preterm births.Preterm PROM is an important cause of perinatal morbidity and mortality.Recent studies suggest an association between Intrauterine infection and both preterm delivery and morbidity of preterm infant. U. Urealyticum is the microorganism most frequently isolated from amniotic fluid of women with preterm labour and PROM.U. urealyticum has been implicated in the genesis of clinical chorioamnioitis, puerperal endometritis, neonatal sepsis and bronchopulmonary dysplasia (chronic lung disease).U. urealyticum isolation in clinical specimens remains a challenge, microbial culture for this organism require special culture conditions and results are generally not availably in time for clinical management decisions.Recently PCR has became an optimal method for the rapid detection of U. urealyticum in clinical specimen.The aim of our study was to determine the frequency and clinical significance for the detection of U. urealyticum in patients with preterm premature rupture of membranes.Our study included 100 patients with preterm premature rupture of membranes with gestational age less than 35 weeks and singleton gestation.Patients participated in our study underwent full history taking and clinical examination.Amniotic fluid was collected by transabdominal amniocentesis guided by ultrasonography and was immediately examined for WBC,s count and sent for microbiologic culture. An aliquot of fluid was stored at -70°C for PCR examination.According to the results of amniotic fluid cultures and PCR for U. urealyticum patients divided into 3 groups:o Group 1: (n.=59) Those with a negative amniotic fluid culture and a negative PCR assay.o Group 2 (n.=15): Those with a negative amniotic fluid culture but a positive PCR for Ureaplasma urealyticum.o Group 3 (n.=26): Those with a positive amniotic fluid culture for microorganisms regardless of the results of PCR.Regarding maternal age of the studied groups, There was no significant differences in the mean age at amniocentesis among the 3 group of patients.The difference in the gestational age at amniocentesis among the 3 groups of patients was not statistically significant, however patients with a positive amniotic fluid culture regardless PCR (group 3) showed the lowest mean gestational age at amniocentesis among the 3 studied groups.Patients with a negative amniotic fluid culture but a positive PCR (group 2) had a significantly higher amniotic fluid white blood cell count than those with a negative amniotic fluid culture and a negative PCR. However, there was no significant difference in the amniotic fluid white blood cell count between patients with a negative amniotic fluid culture but positive PCR and those with a positive amniotic fluid culture.The three studied groups regarding clinical chorioamnionitis revealed no statistically significant difference.Regarding neonatal outcome of studied groups, patients with a negative amniotic fluid culture but positive PCR (group 2) had a significantly higher rate of adverse outcome including low gestational age at birth, low birth weight, and significant neonatal morbidity than those with a negative amniotic fluid culture and negative PCR (group 1). However, no differences were found between patients with a negative culture but positive PCR (group 2) and those with a positive amniotic fluid culture regardless the results of PCR (group 3).SUMMARYPreterm premature rupture of membrane occurs in 3% of pregnancies and is responsible for approximately one-third of all preterm births.Preterm PROM is an important cause of perinatal morbidity and mortality.Recent studies suggest an association between Intrauterine infection and both preterm delivery and morbidity of preterm infant. U. Urealyticum is the microorganism most frequently isolated from amniotic fluid of women with preterm labour and PROM.U. urealyticum has been implicated in the genesis of clinical chorioamnioitis, puerperal endometritis, neonatal sepsis and bronchopulmonary dysplasia (chronic lung disease).U. urealyticum isolation in clinical specimens remains a challenge, microbial culture for this organism require special culture conditions and results are generally not availably in time for clinical management decisions.Recently PCR has became an optimal method for the rapid detection of U. urealyticum in clinical specimen.The aim of our study was to determine the frequency and clinical significance for the detection of U. urealyticum in patients with preterm premature rupture of membranes.Our study included 100 patients with preterm premature rupture of membranes with gestational age less than 35 weeks and singleton gestation.Patients participated in our study underwent full history taking and clinical examination.Amniotic fluid was collected by transabdominal amniocentesis guided by ultrasonography and was immediately examined for WBC,s count and sent for microbiologic culture. An aliquot of fluid was stored at -70°C for PCR examination.According to the results of amniotic fluid cultures and PCR for U. urealyticum patients divided into 3 groups:o Group 1: (n.=59) Those with a negative amniotic fluid culture and a negative PCR assay.o Group 2 (n.=15): Those with a negative amniotic fluid culture but a positive PCR for Ureaplasma urealyticum.o Group 3 (n.=26): Those with a positive amniotic fluid culture for microorganisms regardless of the results of PCR.Regarding maternal age of the studied groups, There was no significant differences in the mean age at amniocentesis among the 3 group of patients.The difference in the gestational age at amniocentesis among the 3 groups of patients was not statistically significant, however patients with a positive amniotic fluid culture regardless PCR (group 3) showed the lowest mean gestational age at amniocentesis among the 3 studied groups.Patients with a negative amniotic fluid culture but a positive PCR (group 2) had a significantly higher amniotic fluid white blood cell count than those with a negative amniotic fluid culture and a negative PCR. However, there was no significant difference in the amniotic fluid white blood cell count between patients with a negative amniotic fluid culture but positive PCR and those with a positive amniotic fluid culture.The three studied groups regarding clinical chorioamnionitis revealed no statistically significant difference.Regarding neonatal outcome of studied groups, patients with a negative amniotic fluid culture but positive PCR (group 2) had a significantly higher rate of adverse outcome including low gestational age at birth, low birth weight, and significant neonatal morbidity than those with a negative amniotic fluid culture and negative PCR (group 1). However, no differences were found between patients with a negative culture but positive PCR (group 2) and those with a positive amniotic fluid culture regardless the results of PCR (group 3).SUMMARYPreterm premature rupture of membrane occurs in 3% of pregnancies and is responsible for approximately one-third of all preterm births.Preterm PROM is an important cause of perinatal morbidity and mortality.Recent studies suggest an association between Intrauterine infection and both preterm delivery and morbidity of preterm infant. U. Urealyticum is the microorganism most frequently isolated from amniotic fluid of women with preterm labour and PROM.U. urealyticum has been implicated in the genesis of clinical chorioamnioitis, puerperal endometritis, neonatal sepsis and bronchopulmonary dysplasia (chronic lung disease).U. urealyticum isolation in clinical specimens remains a challenge, microbial culture for this organism require special culture conditions and results are generally not availably in time for clinical management decisions.Recently PCR has became an optimal method for the rapid detection of U. urealyticum in clinical specimen.The aim of our study was to determine the frequency and clinical significance for the detection of U. urealyticum in patients with preterm premature rupture of membranes.Our study included 100 patients with preterm premature rupture of membranes with gestational age less than 35 weeks and singleton gestation.Patients participated in our study underwent full history taking and clinical examination.Amniotic fluid was collected by transabdominal amniocentesis guided by ultrasonography and was immediately examined for WBC,s count and sent for microbiologic culture. An aliquot of fluid was stored at -70°C for PCR examination.According to the results of amniotic fluid cultures and PCR for U. urealyticum patients divided into 3 groups:o Group 1: (n.=59) Those with a negative amniotic fluid culture and a negative PCR assay.o Group 2 (n.=15): Those with a negative amniotic fluid culture but a positive PCR for Ureaplasma urealyticum.o Group 3 (n.=26): Those with a positive amniotic fluid culture for microorganisms regardless of the results of PCR.Regarding maternal age of the studied groups, There was no significant differences in the mean age at amniocentesis among the 3 group of patients.The difference in the gestational age at amniocentesis among the 3 groups of patients was not statistically significant, however patients with a positive amniotic fluid culture regardless PCR (group 3) showed the lowest mean gestational age at amniocentesis among the 3 studied groups.Patients with a negative amniotic fluid culture but a positive PCR (group 2) had a significantly higher amniotic fluid white blood cell count than those with a negative amniotic fluid culture and a negative PCR. However, there was no significant difference in the amniotic fluid white blood cell count between patients with a negative amniotic fluid culture but positive PCR and those with a positive amniotic fluid culture.The three studied groups regarding clinical chorioamnionitis revealed no statistically significant difference.Regarding neonatal outcome of studied groups, patients with a negative amniotic fluid culture but positive PCR (group 2) had a significantly higher rate of adverse outcome including low gestational age at birth, low birth weight, and significant neonatal morbidity than those with a negative amniotic fluid culture and negative PCR (group 1). However, no differences were found between patients with a negative culture but positive PCR (group 2) and those with a positive amniotic fluid culture regardless the results of PCR (group 3).SUMMARYPreterm premature rupture of membrane occurs in 3% of pregnancies and is responsible for approximately one-third of all preterm births.Preterm PROM is an important cause of perinatal morbidity and mortality.Recent studies suggest an association between Intrauterine infection and both preterm delivery and morbidity of preterm infant. U. Urealyticum is the microorganism most frequently isolated from amniotic fluid of women with preterm labour and PROM.U. urealyticum has been implicated in the genesis of clinical chorioamnioitis, puerperal endometritis, neonatal sepsis and bronchopulmonary dysplasia (chronic lung disease).U. urealyticum isolation in clinical specimens remains a challenge, microbial culture for this organism require special culture conditions and results are generally not availably in time for clinical management decisions.Recently PCR has became an optimal method for the rapid detection of U. urealyticum in clinical specimen.The aim of our study was to determine the frequency and clinical significance for the detection of U. urealyticum in patients with preterm premature rupture of membranes.Our study included 100 patients with preterm premature rupture of membranes with gestational age less than 35 weeks and singleton gestation.Patients participated in our study underwent full history taking and clinical examination.Amniotic fluid was collected by transabdominal amniocentesis guided by ultrasonography and was immediately examined for WBC,s count and sent for microbiologic culture. An aliquot of fluid was stored at -70°C for PCR examination.According to the results of amniotic fluid cultures and PCR for U. urealyticum patients divided into 3 groups:o Group 1: (n.=59) Those with a negative amniotic fluid culture and a negative PCR assay.o Group 2 (n.=15): Those with a negative amniotic fluid culture but a positive PCR for Ureaplasma urealyticum.o Group 3 (n.=26): Those with a positive amniotic fluid culture for microorganisms regardless of the results of PCR.Regarding maternal age of the studied groups, There was no significant differences in the mean age at amniocentesis among the 3 group of patients.The difference in the gestational age at amniocentesis among the 3 groups of patients was not statistically significant, however patients with a positive amniotic fluid culture regardless PCR (group 3) showed the lowest mean gestational age at amniocentesis among the 3 studied groups.Patients with a negative amniotic fluid culture but a positive PCR (group 2) had a significantly higher amniotic fluid white blood cell count than those with a negative amniotic fluid culture and a negative PCR. However, there was no significant difference in the amniotic fluid white blood cell count between patients with a negative amniotic fluid culture but positive PCR and those with a positive amniotic fluid culture.The three studied groups regarding clinical chorioamnionitis revealed no statistically significant difference.Regarding neonatal outcome of studied groups, patients with a negative amniotic fluid culture but positive PCR (group 2) had a significantly higher rate of adverse outcome including low gestational age at birth, low birth weight, and significant neonatal morbidity than those with a negative amniotic fluid culture and negative PCR (group 1). However, no differences were found between patients with a negative culture but positive PCR (group 2) and those with a positive amniotic fluid culture regardless the results of PCR (group 3).SUMMARYPreterm premature rupture of membrane occurs in 3% of pregnancies and is responsible for approximately one-third of all preterm births.Preterm PROM is an important cause of perinatal morbidity and mortality.Recent studies suggest an association between Intrauterine infection and both preterm delivery and morbidity of preterm infant. U. Urealyticum is the microorganism most frequently isolated from amniotic fluid of women with preterm labour and PROM.U. urealyticum has been implicated in the genesis of clinical chorioamnioitis, puerperal endometritis, neonatal sepsis and bronchopulmonary dysplasia (chronic lung disease).U. urealyticum isolation in clinical specimens remains a challenge, microbial culture for this organism require special culture conditions and results are generally not availably in time for clinical management decisions.Recently PCR has became an optimal method for the rapid detection of U. urealyticum in clinical specimen.The aim of our study was to determine the frequency and clinical significance for the detection of U. urealyticum in patients with preterm premature rupture of membranes.Our study included 100 patients with preterm premature rupture of membranes with gestational age less than 35 weeks and singleton gestation.Patients participated in our study underwent full history taking and clinical examination.Amniotic fluid was collected by transabdominal amniocentesis guided by ultrasonography and was immediately examined for WBC,s count and sent for microbiologic culture. An aliquot of fluid was stored at -70°C for PCR examination.According to the results of amniotic fluid cultures and PCR for U. urealyticum patients divided into 3 groups:o Group 1: (n.=59) Those with a negative amniotic fluid culture and a negative PCR assay.o Group 2 (n.=15): Those with a negative amniotic fluid culture but a positive PCR for Ureaplasma urealyticum.o Group 3 (n.=26): Those with a positive amniotic fluid culture for microorganisms regardless of the results of PCR.Regarding maternal age of the studied groups, There was no significant differences in the mean age at amniocentesis among the 3 group of patients.The difference in the gestational age at amniocentesis among the 3 groups of patients was not statistically significant, however patients with a positive amniotic fluid culture regardless PCR (group 3) showed the lowest mean gestational age at amniocentesis among the 3 studied groups.Patients with a negative amniotic fluid culture but a positive PCR (group 2) had a significantly higher amniotic fluid white blood cell count than those with a negative amniotic fluid culture and a negative PCR. However, there was no significant difference in the amniotic fluid white blood cell count between patients with a negative amniotic fluid culture but positive PCR and those with a positive amniotic fluid culture.The three studied groups regarding clinical chorioamnionitis revealed no statistically significant difference.Regarding neonatal outcome of studied groups, patients with a negative amniotic fluid culture but positive PCR (group 2) had a significantly higher rate of adverse outcome including low gestational age at birth, low birth weight, and significant neonatal morbidity than those with a negative amniotic fluid culture and negative PCR (group 1). However, no differences were found between patients with a negative culture but positive PCR (group 2) and those with a positive amniotic fluid culture regardless the results of PCR (group 3).SUMMARYPreterm premature rupture of membrane occurs in 3% of pregnancies and is responsible for approximately one-third of all preterm births.Preterm PROM is an important cause of perinatal morbidity and mortality.Recent studies suggest an association between Intrauterine infection and both preterm delivery and morbidity of preterm infant. U. Urealyticum is the microorganism most frequently isolated from amniotic fluid of women with preterm labour and PROM.U. urealyticum has been implicated in the genesis of clinical chorioamnioitis, puerperal endometritis, neonatal sepsis and bronchopulmonary dysplasia (chronic lung disease).U. urealyticum isolation in clinical specimens remains a challenge, microbial culture for this organism require special culture conditions and results are generally not availably in time for clinical management decisions.Recently PCR has became an optimal method for the rapid detection of U. urealyticum in clinical specimen.The aim of our study was to determine the frequency and clinical significance for the detection of U. urealyticum in patients with preterm premature rupture of membranes.Our study included 100 patients with preterm premature rupture of membranes with gestational age less than 35 weeks and singleton gestation.Patients participated in our study underwent full history taking and clinical examination.Amniotic fluid was collected by transabdominal amniocentesis guided by ultrasonography and was immediately examined for WBC,s count and sent for microbiologic culture. An aliquot of fluid was stored at -70°C for PCR examination.According to the results of amniotic fluid cultures and PCR for U. urealyticum patients divided into 3 groups:o Group 1: (n.=59) Those with a negative amniotic fluid culture and a negative PCR assay.o Group 2 (n.=15): Those with a negative amniotic fluid culture but a positive PCR for Ureaplasma urealyticum.o Group 3 (n.=26): Those with a positive amniotic fluid culture for microorganisms regardless of the results of PCR.Regarding maternal age of the studied groups, There was no significant differences in the mean age at amniocentesis among the 3 group of patients.The difference in the gestational age at amniocentesis among the 3 groups of patients was not statistically significant, however patients with a positive amniotic fluid culture regardless PCR (group 3) showed the lowest mean gestational age at amniocentesis among the 3 studied groups.Patients with a negative amniotic fluid culture but a positive PCR (group 2) had a significantly higher amniotic fluid white blood cell count than those with a negative amniotic fluid culture and a negative PCR. However, there was no significant difference in the amniotic fluid white blood cell count between patients with a negative amniotic fluid culture but positive PCR and those with a positive amniotic fluid culture.The three studied groups regarding clinical chorioamnionitis revealed no statistically significant difference.Regarding neonatal outcome of studied groups, patients with a negative amniotic fluid culture but positive PCR (group 2) had a significantly higher rate of adverse outcome including low gestational age at birth, low birth weight, and significant neonatal morbidity than those with a negative amniotic fluid culture and negative PCR (group 1). However, no differences were found between patients with a negative culture but positive PCR (group 2) and those with a positive amniotic fluid culture regardless the results of PCR (group 3).SUMMARYPreterm premature rupture of membrane occurs in 3% of pregnancies and is responsible for approximately one-third of all preterm births.Preterm PROM is an important cause of perinatal morbidity and mortality.Recent studies suggest an association between Intrauterine infection and both preterm delivery and morbidity of preterm infant. U. Urealyticum is the microorganism most frequently isolated from amniotic fluid of women with preterm labour and PROM.U. urealyticum has been implicated in the genesis of clinical chorioamnioitis, puerperal endometritis, neonatal sepsis and bronchopulmonary dysplasia (chronic lung disease).U. urealyticum isolation in clinical specimens remains a challenge, microbial culture for this organism require special culture conditions and results are generally not availably in time for clinical management decisions.Recently PCR has became an optimal method for the rapid detection of U. urealyticum in clinical specimen.The aim of our study was to determine the frequency and clinical significance for the detection of U. urealyticum in patients with preterm premature rupture of membranes.Our study included 100 patients with preterm premature rupture of membranes with gestational age less than 35 weeks and singleton gestation.Patients participated in our study underwent full history taking and clinical examination.Amniotic fluid was collected by transabdominal amniocentesis guided by ultrasonography and was immediately examined for WBC,s count and sent for microbiologic culture. An aliquot of fluid was stored at -70°C for PCR examination.According to the results of amniotic fluid cultures and PCR for U. urealyticum patients divided into 3 groups:o Group 1: (n.=59) Those with a negative amniotic fluid culture and a negative PCR assay.o Group 2 (n.=15): Those with a negative amniotic fluid culture but a positive PCR for Ureaplasma urealyticum.o Group 3 (n.=26): Those with a positive amniotic fluid culture for microorganisms regardless of the results of PCR.Regarding maternal age of the studied groups, There was no significant differences in the mean age at amniocentesis among the 3 group of patients.The difference in the gestational age at amniocentesis among the 3 groups of patients was not statistically significant, however patients with a positive amniotic fluid culture regardless PCR (group 3) showed the lowest mean gestational age at amniocentesis among the 3 studied groups.Patients with a negative amniotic fluid culture but a positive PCR (group 2) had a significantly higher amniotic fluid white blood cell count than those with a negative amniotic fluid culture and a negative PCR. However, there was no significant difference in the amniotic fluid white blood cell count between patients with a negative amniotic fluid culture but positive PCR and those with a positive amniotic fluid culture.The three studied groups regarding clinical chorioamnionitis revealed no statistically significant difference.Regarding neonatal outcome of studied groups, patients with a negative amniotic fluid culture but positive PCR (group 2) had a significantly higher rate of adverse outcome including low gestational age at birth, low birth weight, and significant neonatal morbidity than those with a negative amniotic fluid culture and negative PCR (group 1). However, no differences were found between patients with a negative culture but positive PCR (group 2) and those with a positive amniotic fluid culture regardless the results of PCR (group 3).SUMMARYPreterm premature rupture of membrane occurs in 3% of pregnancies and is responsible for approximately one-third of all preterm births.Preterm PROM is an important cause of perinatal morbidity and mortality.Recent studies suggest an association between Intrauterine infection and both preterm delivery and morbidity of preterm infant. U. Urealyticum is the microorganism most frequently isolated from amniotic fluid of women with preterm labour and PROM.U. urealyticum has been implicated in the genesis of clinical chorioamnioitis, puerperal endometritis, neonatal sepsis and bronchopulmonary dysplasia (chronic lung disease).U. urealyticum isolation in clinical specimens remains a challenge, microbial culture for this organism require special culture conditions and results are generally not availably in time for clinical management decisions.Recently PCR has became an optimal method for the rapid detection of U. urealyticum in clinical specimen.The aim of our study was to determine the frequency and clinical significance for the detection of U. urealyticum in patients with preterm premature rupture of membranes.Our study included 100 patients with preterm premature rupture of membranes with gestational age less than 35 weeks and singleton gestation.Patients participated in our study underwent full history taking and clinical examination.Amniotic fluid was collected by transabdominal amniocentesis guided by ultrasonography and was immediately examined for WBC,s count and sent for microbiologic culture. An aliquot of fluid was stored at -70°C for PCR examination.According to the results of amniotic fluid cultures and PCR for U. urealyticum patients divided into 3 groups:o Group 1: (n.=59) Those with a negative amniotic fluid culture and a negative PCR assay.o Group 2 (n.=15): Those with a negative amniotic fluid culture but a positive PCR for Ureaplasma urealyticum.o Group 3 (n.=26): Those with a positive amniotic fluid culture for microorganisms regardless of the results of PCR.Regarding maternal age of the studied groups, There was no significant differences in the mean age at amniocentesis among the 3 group of patients.The difference in the gestational age at amniocentesis among the 3 groups of patients was not statistically significant, however patients with a positive amniotic fluid culture regardless PCR (group 3) showed the lowest mean gestational age at amniocentesis among the 3 studied groups.Patients with a negative amniotic fluid culture but a positive PCR (group 2) had a significantly higher amniotic fluid white blood cell count than those with a negative amniotic fluid culture and a negative PCR. However, there was no significant difference in the amniotic fluid white blood cell count between patients with a negative amniotic fluid culture but positive PCR and those with a positive amniotic fluid culture.The three studied groups regarding clinical chorioamnionitis revealed no statistically significant difference.Regarding neonatal outcome of studied groups, patients with a negative amniotic fluid culture but positive PCR (group 2) had a significantly higher rate of adverse outcome including low gestational age at birth, low birth weight, and significant neonatal morbidity than those with a negative amniotic fluid culture and negative PCR (group 1). However, no differences were found between patients with a negative culture but positive PCR (group 2) and those with a positive amniotic fluid culture regardless the results of PCR (group 3).SUMMARYPreterm premature rupture of membrane occurs in 3% of pregnancies and is responsible for approximately one-third of all preterm births.Preterm PROM is an important cause of perinatal morbidity and mortality.Recent studies suggest an association between Intrauterine infection and both preterm delivery and morbidity of preterm infant. U. Urealyticum is the microorganism most frequently isolated from amniotic fluid of women with preterm labour and PROM.U. urealyticum has been implicated in the genesis of clinical chorioamnioitis, puerperal endometritis, neonatal sepsis and bronchopulmonary dysplasia (chronic lung disease).U. urealyticum isolation in clinical specimens remains a challenge, microbial culture for this organism require special culture conditions and results are generally not availably in time for clinical management decisions.Recently PCR has became an optimal method for the rapid detection of U. urealyticum in clinical specimen.The aim of our study was to determine the frequency and clinical significance for the detection of U. urealyticum in patients with preterm premature rupture of membranes.Our study included 100 patients with preterm premature rupture of membranes with gestational age less than 35 weeks and singleton gestation.Patients participated in our study underwent full history taking and clinical examination.Amniotic fluid was collected by transabdominal amniocentesis guided by ultrasonography and was immediately examined for WBC,s count and sent for microbiologic culture. An aliquot of fluid was stored at -70°C for PCR examination.According to the results of amniotic fluid cultures and PCR for U. urealyticum patients divided into 3 groups:o Group 1: (n.=59) Those with a negative amniotic fluid culture and a negative PCR assay.o Group 2 (n.=15): Those with a negative amniotic fluid culture but a positive PCR for Ureaplasma urealyticum.o Group 3 (n.=26): Those with a positive amniotic fluid culture for microorganisms regardless of the results of PCR.Regarding maternal age of the studied groups, There was no significant differences in the mean age at amniocentesis among the 3 group of patients.The difference in the gestational age at amniocentesis among the 3 groups of patients was not statistically significant, however patients with a positive amniotic fluid culture regardless PCR (group 3) showed the lowest mean gestational age at amniocentesis among the 3 studied groups.Patients with a negative amniotic fluid culture but a positive PCR (group 2) had a significantly higher amniotic fluid white blood cell count than those with a negative amniotic fluid culture and a negative PCR. However, there was no significant difference in the amniotic fluid white blood cell count between patients with a negative amniotic fluid culture but positive PCR and those with a positive amniotic fluid culture.The three studied groups regarding clinical chorioamnionitis revealed no statistically significant difference.Regarding neonatal outcome of studied groups, patients with a negative amniotic fluid culture but positive PCR (group 2) had a significantly higher rate of adverse outcome including low gestational age at birth, low birth weight, and significant neonatal morbidity than those with a negative amniotic fluid culture and negative PCR (group 1). However, no differences were found between patients with a negative culture but positive PCR (group 2) and those with a positive amniotic fluid culture regardless the results of PCR (group 3).