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Premature Rupture of Membranes

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2521. Maternal and obstetric risk factors for sudden infant death syndrome in the United States. (Abstract)

] 1.24, 2.33), abruptio placentae (OR 1.57; 95% CI 1.24, 1.98), premature rupture of membranes (OR 1.48; 95% CI 1.33, 1.66), or small for gestational age (OR 1.40; 95% CI 1.30, 1.50 for the 10th percentile). SIDS cases were also more likely to be male. Mothers of cases were more likely to be younger, less educated, and nonwhite, and more of them smoked during pregnancy and did not attend prenatal care.This analysis confirms the importance of several well known demographic and lifestyle risk factors

2004 Obstetrics and Gynecology

2522. Second-trimester asynchronous multifetal delivery results in poor perinatal outcome. (Abstract)

attempt (tocolysis and/or emergent cerclage placement) to increase latency between delivery of the first fetus and subsequent fetuses.Fourteen cases of asynchronous delivery were identified out of 96922 deliveries including 1352 pregnancies complicated by multifetal gestation. The occurrence rate of asynchronous delivery was 0.14 per 1000 births. The etiology of preterm birth of the first fetus in 12 (86%) of 14 cases was second-trimester rupture of membranes. The mean gestational age for delivery (...) of the first fetus was 21.+/- 2.0 weeks. All women received tocolysis and intravenous antibiotics. Two of 3 attempts at cerclage placement were successful. Median latency obtained was 2 days (range less than 1-70 days). There was 1 survival of a first born. There were 19 retained fetuses, 2 died in utero, 10 died between birth and day 57 of life, and 7 survived (37%; 95% confidence interval 16%, 62%) until hospital discharge. Six of 7 survivors had major sequelae from prematurity. One of 19 fetuses

2004 Obstetrics and Gynecology

2523. Surgical management of twin reversed arterial perfusion sequence. (Abstract)

with no incidence of premature rupture of membranes, with 83% perinatal survival, and with a significantly greater gestational age at delivery (36 weeks). There were no significant differences in perinatal outcome relative to the specific surgical technique that was used.Surgical management of twin reversed arterial perfusion sequence is indicated in high-risk patients. The surgical approach and the surgical technique should be tailored to the specific clinical presentation, preferably by performing the surgery (...) who had umbilical cord occlusion was 65% (33/51 patients) versus 42.9% (6/14 patients) for the surgical candidates who did not undergo umbilical cord occlusion (P = .1). However, perinatal outcomes in surgical patients were significantly better than expectantly treated surgical candidates if the dividing membrane was not disrupted purposely (22/28 patients; 78.5%; P = .02). Surgery within the sac of the twin reversed arterial perfusion fetus was feasible in 23.5% of patients and was associated

2006 American Journal of Obstetrics and Gynecology

2524. Pregnancy and infant outcome of 80 consecutive cord coagulations in complicated monochorionic multiple pregnancies. (Abstract)

intrauterine fetal deaths (10%), 5 within 24 hours and 4 between 4 and 10 weeks after the procedure. There was 1 termination of pregnancy because of chorioamnionitis. Median gestational age at delivery was 35.4 weeks, with 79% of patients delivering after 32 weeks. Preterm prelabor rupture of the membranes before 25 weeks accounted for all perinatal deaths (n = 5). Of the children older than 1 year of age (n = 67), 62 (92%) have a normal development.Cord coagulation is an effective method for selective

2006 American Journal of Obstetrics and Gynecology

2525. Maternal morbidity after maternal-fetal surgery. (Abstract)

cases by percutaneous techniques. There were no maternal deaths, but significant short-term morbidity was observed. There were no significant differences in the incidence of premature rupture of membranes, pulmonary edema, placental abruption, postoperative vaginal bleeding, preterm delivery, or interval from maternal-fetal surgery to delivery between endoscopic procedures and open surgery. Complications were significantly less in the percutaneous ultrasound-guided procedures. Endoscopic procedures (...) , even with a laparotomy, showed statistically significantly less morbidity compared with the open hysterotomy group regarding cesarean delivery as delivery mode (94.8% vs 58.8%; P < .001), requirement for intensive care unit stay (1.4% vs 26.4%; P < .001), length of hospital stay (7.9 vs 11.9 days; P = .001), and requirement for blood transfusions (2.9% vs 12.6%; P = .022). Chorion-amnion membrane separation (64.7% vs 20.3%; P < .001) was seen more often in the endoscopy group.Short-term morbidities

2006 American Journal of Obstetrics and Gynecology

2526. Contemporary risks of maternal morbidity and adverse outcomes with increasing maternal age and plurality. Full Text available with Trip Pro

, incompetent cervix, tocolysis, premature rupture of membranes, excessive bleeding at delivery, delivery <29 weeks, and infant death.Compared to singletons, the risks for all adverse outcomes among multiple pregnancies were significantly elevated, and were highest for tocolysis, delivery <29 weeks, and infant mortality. Within pluralities, increasing maternal age was associated with significantly higher risks of pregnancy-associated hypertension, excessive bleeding, and incompetent cervix, but for twin (...) preterm birth, and infant mortality.

2007 Fertility and Sterility

2527. Manufacture of a cell-free amnion matrix scaffold that supports amnion cell outgrowth in vitro. (Abstract)

Manufacture of a cell-free amnion matrix scaffold that supports amnion cell outgrowth in vitro. We manufactured a cell-free extracellular matrix scaffolds in order to obtain a support material for amnion cell outgrowth, eventually being used for repair of prematurely ruptured fetal membrane. Human preterm or term amnion tissue was separated into its collagenous extracellular matrix and cell components. The acellular scaffold was explored for its capacity to support regrowth of isolated human (...) found to grow into dense layers on the surface of the scaffold within 3-4 days and 7-8 days, respectively, and to some extent, invaded the scaffold during the culture period. Manufactured acellular amnion matrix retains structural and functional properties required for cell outgrowth in vitro. It may become useful to repair prematurely ruptured fetal membranes.

2007 Placenta

2528. Risk factors for adverse outcomes in spontaneous versus assisted conception twin pregnancies. (Abstract)

Risk factors for adverse outcomes in spontaneous versus assisted conception twin pregnancies. To evaluate risk factors for adverse outcomes in spontaneous vs. assisted conception twin pregnancies.Historical cohort study.Four academic tertiary medical centers.Women with twin pregnancies, including 2,143 spontaneous and 424 assisted conception; 2,492 nonreduced and 75 reduced.None (observational).Preeclampsia, preterm premature rupture of membranes, birth <32 weeks and <30 weeks, low birth weight (...) , very low birth weight, and slowed midgestation fetal growth (<10th percentile between 20 and 28 weeks).Among nonreduced pregnancies, assisted conception was not significantly associated with any adverse outcomes; among nulliparas, the risk for preeclampsia was increased regardless of method of conception; among spontaneous conceptions, the risks for preterm premature rupture of membranes, low birth weight, very low birth weight, and slowed midgestation fetal growth were increased. Among all

2004 Fertility and Sterility

2529. Umbilical cord prolapse. (Abstract)

Umbilical cord prolapse. Prolapse of the umbilical cord is a rare obstetric emergency that in the viable fetus necessitates an expeditious delivery. A case of a periviable pregnancy complicated by preterm premature rupture of membranes and overt umbilical cord prolapse was prolonged 2 weeks with expectant management is described. An extensive review of the literature regarding the etiology, risk factors, and management options for umbilical cord prolapse in both viable and previable pregnancies

2006 Obstetrical & Gynecological Survey

2530. Outcome of pregnancies among Hispanics: revisiting the epidemiologic paradox. (Abstract)

less likely to have preterm premature rupture of membranes (AOR 0.66, 95% CI 0.58-0.75, p < 0.0001).Hispanics have the lowest PTD and LBW rates when compared to non-Hispanic whites and blacks. (...) Outcome of pregnancies among Hispanics: revisiting the epidemiologic paradox. To evaluate the outcome of pregnancies among Hispanics in a tertiary care hospital in Miami, Florida.Retrospective study of all women who delivered in our institution over an 11-year period. Outcome variables were stratified by race/ethnicity groups: Hispanics, non-Hispanic blacks and non-Hispanic whites. Variables included rates of low birth weight (LBW), preterm delivery (PTD) and other selected pregnancy

2006 Journal of Reproductive Medicine

2531. Sjögren's syndrome diagnosed in pregnancy: a case report. (Abstract)

for renal insufficiency. To prevent autoantibody formation, progression of the disease, therapy with methyl prednisolone, 100 mg/d intravenously; cyclophosphamide, 500 mg/month in a single intravenous application; hemodialysis 3 times a week; and plasmapheresis 7 times was instituted. An 1,100-g, male infant at 27 weeks and 5 days was delivered by cesarean section because of premature preterm rupture of membranes and severe late decelerations on cardiotocography. The infant was discharged from (...) the neonatal intensive care unit after 30 days, weighing 1,800 g. Postnatal echocardiographic examination of the infant revealed neither cardiac malformations nor arrhythmias.Since the presence of autoantibodies against SS-A and SS-B are reported to accompany congenital heart block, the primary goal of therapy should be preventing this untoward effect of the disease. Close monitoring during pregnancy is mandatory to detect preeclampsia, intrauterine growth retardation and preterm labor.

2005 Journal of Reproductive Medicine

2532. Rapid growth of a fetal sacrococcygeal teratoma in an HIV-infected woman: a case report. (Abstract)

, seizure disorder and tobacco use, presented with premature rupture of membranes. Ultrasound examination at 17 weeks' gestation showed normal fetal anatomy. Cesarean delivery was complicated by difficulty delivering a live infant with a large sacral mass. Successful surgical excision of a 650-g mass and stabilization of the infant occurred in the neonatal period.This is the first case report to describe a rapidly growing sacrococcygeal teratoma in a neonate from a pregnancy complicated by HIV

2006 Journal of Reproductive Medicine

2533. Early-onset neonatal group B streptococcal infection in London: 1990-1999. Full Text available with Trip Pro

origin, and those who had had a previously affected infant, multiple pregnancy, preterm delivery, prolonged rupture of membranes or intrapartum fever all had a significantly increased risk of delivering an infected infant.These data suggest that the incidence of early-onset group B streptococcal infection in these London centres is sufficiently high to warrant administration of intrapartum antibiotics to at-risk women.

2004 BJOG

2534. The relationship between delivery mode and mortality in very low birthweight singleton vertex-presenting infants. (Abstract)

and gestational age, small for gestational age infants, maternal hypertensive disorders and antepartum haemorrhage, and was inversely related to premature labour and prolonged rupture of membranes. Factors associated with increased survival were increasing gestational age, antenatal corticosteroid therapy, maternal hypertensive disorders and no amnionitis. Mortality rate prior to discharge was lower after caesarean delivery (13.2% vs 21.8%), but in the multivariate analysis, adjusting for the other risk

2004 BJOG

2535. Pregnancy following uterine artery embolisation for symptomatic fibroids: a series of 26 completed pregnancies. Full Text available with Trip Pro

preterm deliveries and the caesarean section rate was 88%. Two (13%) women developed proteinuric hypertension and two others had preterm spontaneous rupture of the membranes. Fourteen of 16 cases were delivered by caesarean section. The rate of primary postpartum haemorrhage was 3/15 (20%). The mean birthweight of term babies was 3.39 kg (SD 0.64) and none required admission to neonatal intensive care. There was one (6.7%) case of fetal growth restriction.Although this study is relatively small

2005 BJOG

2536. Tocolytic therapy and clinical experience. Combination therapy. Full Text available with Trip Pro

Tocolytic therapy and clinical experience. Combination therapy. Inhibiting preterm labour at extremely early gestations.Observational study. Case reports.Perinatal Centre Lund University Hospital, South Sweden.Twenty-five women (13 cases with intact membranes and 12 cases with ruptured) with threatened preterm labour and advanced cervical status before 26 completed weeks of gestation.A combination of different drugs was used. Atosiban, an oxytocin antagonist, was the first line drug

2005 BJOG

2537. Procedure-related complications of rapid amniodrainage in the treatment of polyhydramnios. Full Text available with Trip Pro

(singleton/twin), cause of polyhydramnios, gestational age at amniocentesis, volume of amniotic fluid drained, duration of the procedure, other intrauterine procedures in addition to the amniodrainage, and procedure-related complications including placental abruption, premature rupture of membranes (PROM), chorioamnionitis, fetal bradycardia and preterm delivery within 48 h of amniodrainage.Seventy-four consecutive women had 134 rapid amniodrainage procedures during the study period. Four procedures were

2004 Ultrasound in Obstetrics and Gynecology

2538. Accuracy of sonographically estimated fetal weight in 840 women with different pregnancy complications prior to induction of labor. Full Text available with Trip Pro

abdominal circumference and femur length. The EFW was compared with the weight at delivery, 1-3 days later.There was a high correlation between EFW and birth weight (R(2) = 0.775, P < 0.001). The mean birth weight was 3207 +/- 561 g, and mean absolute weight difference was 227 +/- 197 g; (absolute range, 0-1700 g; actual range, - 986 to + 1700 g). The mean weight difference was significantly different between the patients with LGA infants, FGR infants and preterm premature rupture of membranes (PPROM (...) January 1999 and December 2000. All underwent detailed ultrasound assessment for EFW, amniotic fluid index, biophysical profile and placental location. Indications included previous Cesarean section, postdate pregnancy, pregnancy-induced hypertension, diabetic pregnancy, suspected large-for-gestational age (LGA) infants, suspected fetal growth restriction (FGR), oligohydramnios, decreased fetal movements, premature rupture of membranes at or before term. EFW was calculated after measuring fetal

2004 Ultrasound in Obstetrics and Gynecology

2539. Urolithiasis in pregnancy: Current diagnosis, treatment, and pregnancy complications. (Abstract)

of pregnancy. Conservative management is the first-line treatment for noncomplicated urolithiasis in pregnancy. If spontaneous passage of the stone does not occur or if complications develop, urologic consultation should be obtained. Several obstetric complications have been associated with urolithiasis, including preterm labor and preterm premature rupture of membranes, although the reported rates of these complications in association with urolithiasis vary widely and overlap normal background rates

2006 Obstetrical & Gynecological Survey

2540. Perinatal infections due to group B streptococci. (Abstract)

, new national guidelines were released recommending 1) solely a screen-based prevention strategy, 2) a new algorithm for patients with penicillin allergy, and 3) more specific practices in certain clinical scenarios. Yet many clinical issues remain, including implementation of new diagnostic techniques, management of preterm rupture of membranes, use of alternative antibiotic approaches, improvement of compliance, prevention of low birth weight infants, emergence of resistant organisms, and vaccine

2004 Obstetrics and Gynecology

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