[Gram staining and bacterial culture of stomach contents of the full-term neonate in prolonged status of ruptured membranes is not useful].

In an effort to evaluate the management of full-term neonates born after prolonged rupture of the membranes, we studied 159 full-term newborn infants born 24 hours or more after rupture of the membranes retrospectively. Gram stain and bacterial culture of a gastric aspirate of the neonates were significantly related; however, the predictive value of the Gram stain was low, both for a positive test (46%) and for a negative test (70%). A significant relation was not found between the Gram stain (presence of bacteria or greater than or equal to 4 leucocytes per high power field) or the bacterial culture on the one hand and the occurrence of clinical symptoms of infection on the other. In all cases the decision to treat the newborn with antibiotics was made on the basis of the clinical symptoms alone. In our opinion the routine study of Gram stain and bacterial culture of a gastric aspirate of full-term neonates born after prolonged rupture of the membranes is not useful; observation alone is sufficient.