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The Mercer protocol is a common regimen for antibiotic prophylaxis in the context of preterm premature rupture of membranes (PPROM) during pregnancy, when immediate delivery is contraindicated due to known or suspected fetal lung immaturity. It was first described by Mercer et al. in 1997. [1]
Regions with low neonatal mortality include Europe, the Western Pacific, and the Americas, which have sepsis rates that account for 9.1% to 15.3% of the total neonatal deaths worldwide. This is in contrast with the 22.5 to 27.2% percentage of total deaths in resource-poor countries such as Nigeria, the Democratic Republic of the Congo, India ...
Pregnancy increases the clearance of ampicillin by up to 50%, and a higher dose is thus needed to reach therapeutic levels. [25] [27] Ampicillin crosses the placenta and remains in the amniotic fluid at 50–100% of the concentration in maternal plasma; this can lead to high concentrations of ampicillin in the newborn. [27]
This scoring allows for the estimation of age in the range of 26 weeks to 44 weeks. The New Ballard Score is an extension of the above to include extremely pre-term babies , i.e., up to 20 weeks. The scoring relies on the intra-uterine changes that the fetus undergoes during its maturation.
In agar and broth dilution methods, bacteria are placed in multiple small tubes with different concentrations of antibiotics. [14] Whether a bacterium is sensitive or not is determined by visual inspection or automatic optical methods, after a period of incubation. [5] Broth dilution is considered the gold standard for phenotypic testing. [14]
An AFI between 8 and 18 cm is considered normal. [5] Median AFI level is approximately 14 cm from week 20 to week 35, [ 6 ] when the amniotic fluid begins to reduce in preparation for birth. An AFI smaller than 5–6 cm is considered as oligohydramnios . [ 3 ]
[14] [12] However, all NSAIDs showed association with structural cardiac defects with usage during the early weeks of pregnancy. When ibuprofen and naproxen are used within the third trimester, there is a significant increase in the risk of premature closure of the ductus arteriosus with primary pulmonary hypertension in the newborn. [ 12 ]