Question:
A lady presented with features of threatened abortion at 32 weeks of pregnancy. Which of the following statements with regard to antibiotic usage is not correct?
A lady presented with features of threatened abortion at 32 weeks of pregnancy. Which of the following statements with regard to antibiotic usage is not correct?
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Recall ORACLE II: prophylaxis with intact membranes gives no benefit.
Updated On: Jun 24, 2026
- Antibiotic prophylaxis even with unruptured membranes
- Metronidazole if asymptomatic but significant bacterial vaginosis
- Antibiotics if asymptomatic but significant bacteriuria
- Antibiotics for preterm premature rupture of membranes
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The Correct Option is A
Solution and Explanation
Step 1: The question asks which statement about antibiotic use in threatened preterm labour is incorrect. The evidence base is the ORACLE trials and standard obstetric guidance.
Step 2: Routine antibiotic prophylaxis when membranes are intact (unruptured) does not help and may even harm. The ORACLE II trial showed no benefit in preterm labour with intact membranes and signalled possible long-term harm to the child. So giving antibiotics with unruptured membranes is not correct. Option A is the wrong statement and therefore the answer.
Step 3: Treating significant bacterial vaginosis with metronidazole even if asymptomatic is reasonable in pregnancy because BV is linked to preterm birth, so option B is a correct statement.
Step 4: Asymptomatic bacteriuria in pregnancy must be treated to prevent pyelonephritis and preterm labour, so option C (antibiotics for significant bacteriuria) is correct.
Step 5: Preterm premature rupture of membranes is a clear indication for antibiotics (erythromycin), which prolong latency and reduce infection. Option D is correct.
The statement that is not correct is option A, antibiotic prophylaxis with unruptured membranes.
Step 2: Routine antibiotic prophylaxis when membranes are intact (unruptured) does not help and may even harm. The ORACLE II trial showed no benefit in preterm labour with intact membranes and signalled possible long-term harm to the child. So giving antibiotics with unruptured membranes is not correct. Option A is the wrong statement and therefore the answer.
Step 3: Treating significant bacterial vaginosis with metronidazole even if asymptomatic is reasonable in pregnancy because BV is linked to preterm birth, so option B is a correct statement.
Step 4: Asymptomatic bacteriuria in pregnancy must be treated to prevent pyelonephritis and preterm labour, so option C (antibiotics for significant bacteriuria) is correct.
Step 5: Preterm premature rupture of membranes is a clear indication for antibiotics (erythromycin), which prolong latency and reduce infection. Option D is correct.
The statement that is not correct is option A, antibiotic prophylaxis with unruptured membranes.
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