Moreover, given the increasing antibiotic resistance, alerts have been issued about the use and abuse of prophylactic antibiotic administration. These practices may in turn affect several women in the positive experience of birth. Therefore, from PROM, diagnosis may derive different medical procedures such as hospitalization, antibiotic prophylaxis, and induction of labour through oxytocin, that is, increased medicalization and caesarean section rates. Foetal complications of PROM include neonatal sepsis, abnormal foetal presentation, cord prolapse or compression, and abruptio placentae, and these may increase the risk of neonatal intraventricular haemorrhage, leading to neurodevelopmental disability as a direct consequence. The most commonly diagnosed maternal infections in case of PROM are chorioamnionitis and endometritis, which may be further promoted by frequent vaginal exams and the presence of meconium in the amniotic fluid (AF). Foetal membranes are of pivotal importance because they offer a robust barrier against infection ascending from the reproductive tract after their rupture, both the mother and foetus are at risk of infection and other complications.
It can be observed at any gestational age and occurs in approximately 10% of pregnant women and in roughly 40% of preterm deliveries. Among these, premature rupture of membranes (PROM) consists of the rupture of the foetal membranes before the onset of labour. The early diagnosis of pregnancy-related complications and the prediction of pregnancy outcome are considered strategic clinical goals to ensure the health of mothers and of their babies. GC-MS analysis, followed by univariate and multivariate statistical analysis, was able to discriminate among the different classes, highlighting the metabolites most involved in the discrimination. For this project, urine samples were collected at three different clinical conditions: out of labour before PROM occurrence (Ph1), out of labour with PROM (Ph2), and during labour with PROM (Ph3). In particular, this study focuses on premature rupture of membranes (PROM) in pregnancy at term. In fact, metabolomics has proved to be an efficient strategy for the description of several perinatal conditions. Since pathologies and complications occurring during pregnancy and/or during labour may cause adverse outcomes for both newborns and mothers, there is a growing interest in metabolomic applications on pregnancy investigation.
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