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Premature Rupture of Membranes

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2601. Pregnancy following gastric bypass for morbid obesity: effect of surgery-to-conception interval on maternal and neonatal outcomes. (Abstract)

of 18 months. Pregnancy and newborn outcomes excluding miscarriages were compared using the chi-square or unpaired t-test for dichotomous and continuous variables, respectively.Twenty subjects conceived 18 months (47.5+/-41) after RYGB, p< .05. Maternal age, parity, body mass index, and weight gain were similar by group. There were no statistically significant differences in adverse obstetrical outcomes (preterm premature membrane rupture (...) , gestational diabetes, oligohydramnios, intrauterine growth restriction, preterm or post-term delivery) or adverse newborn outcomes (5-min Apgar score <7, intensive care admission, or birth defect).Obstetrical and neonatal outcomes are similar in women conceiving during or after the period of maximal weight loss following RYGB.

2008 Obesity Surgery

2602. Maternal morbidity and infant death in twin vs triplet and quadruplet pregnancies. (Abstract)

and were controlled for maternal age, race, parity, and smoking status.Compared with mothers of twins, mothers of triplets and quadruplets were more likely to be diagnosed with preterm premature rupture of membranes (AORs, 1.53, 1.74, respectively), pregnancy-associated hypertension (AORs, 1.22, 1.27), and excessive bleeding (AORs, 1.50, 2.22), to require tocolysis (AORs, 2.85, 5.03), and to be delivered by cesarean (AORs, 6.55, 7.38) at < 29 weeks of gestation (AORs, 3.76, 7.96), and to have > or = 1

2008 American Journal of Obstetrics and Gynecology

2603. Approach to term neonates born after maternal intrapartum fever and unknown maternal group B Streptococcus status: value of serum C-reactive protein and 16S rRNA gene PCR amplification. (Abstract)

Approach to term neonates born after maternal intrapartum fever and unknown maternal group B Streptococcus status: value of serum C-reactive protein and 16S rRNA gene PCR amplification. Thirty-six term neonates born after maternal intrapartum fever, with premature rupture of membranes <18 hours and unknown maternal group B Streptococcus status had blood samples for complete blood count, C-reactive protein, culture, and 16S rRNA gene polymerase chain reaction amplification. Only 2 neonates were

2007 Pediatric Infectious Dsease Journal

2604. Obstetric outcomes in nulliparous young adolescents. (Abstract)

age 20-29. Multiple gestations were excluded. Young adolescents were more likely to develop anemia, preterm delivery, preeclampsia and deliver low birth weight neonates. More cases in the young adolescent group did not have antenatal care. Cephalopelvic disproportion occurred less often in the young adolescent group. No differences were observed between the groups regarding the prevalence of premature rupture of membranes, cesarean section, low Apgar score and fetal demise. Adolescents under 15

2007 Southeast Asian Journal of Tropical Medicine and Public Health

2605. Teenage pregnancies and their obstetric outcomes. (Abstract)

), eclampsia (RR 1.95, P value <0.05), preterm labour (RR 1.25, P value <0.001), intrauterine growth retardation (RR 2.29, P value <0.001) and low birth weight (RR 1.24, P value <0.001). Assisted delivery (11.78% versus 2.23%, P value <0.001) was significantly more common and caesarean delivery (9.64% versus 17.18%, P value <0.001) was significantly less common in teenagers. Moderate anaemia, mild pregnancy-induced hypertension, preeclampsia, premature rupture of membranes, antepartum haemorrhage and post

2007 Tropical Doctor

2606. The intensity of the fetal inflammatory response in intraamniotic inflammation with and without microbial invasion of the amniotic cavity. (Abstract)

infection and cases with negative AF cultures.The FIR was examined in 89 cases of women with preterm premature rupture of membranes who delivered singleton preterm newborn infants within 48 hours of amniocentesis. AF was cultured for aerobic and anaerobic bacteria and for genital mycoplasmas. AF white blood cell (WBC) count and matrix metalloproteinase-8 (MMP-8) determinations were performed to assess the presence of intraamniotic inflammation. Intraamniotic inflammation was defined as an elevated AF

2007 American Journal of Obstetrics and Gynecology

2607. Abruptio placentae in the setting of an atypical presentation of acute appendicitis: a case report. (Abstract)

Abruptio placentae in the setting of an atypical presentation of acute appendicitis: a case report. Causes of placental abruption include traumatic events, cocaine use, hypertension, cigarette smoking and advanced maternal age. Recent studies also implicate inflammatory precursors, such as preterm premature rupture of membranes and chorioamnionitis. Clear precipitating events are often not identified, and precise etiologic determinants are still being determined.A 25-year-old woman, grayida 4 (...) , para 2012, presented with acute onset of severe abdominal pain; frequent, low-amplitude contractions; and a nonreassuring fetal heart tracing. While performing an urgent cesarean section for acute placental abruption, a ruptured appendicitis was identified.This case suggests that appendicitis in the third trimester may be a risk factor for placental abruption.

2008 Journal of Reproductive Medicine

2608. Pseudoamniotic band syndrome: a rare complication of monochorionic twins with fetofetal transfusion syndrome treated by laser coagulation. (Abstract)

. In 5 (62.5%) and 7 (87.5%) cases, PABS occurred after premature rupture of membranes and intrauterine death of the donor, respectively. In 4 cases (50%), there was both premature rupture of membranes (PROM) and intrauterine fetal death; in 3 cases (37.5%), there was intrauterine fetal death alone, and in 1 case (12.5%), there was PROM alone. In the remaining 430 cases, PROM occurred in 62 cases (14.4%) and 66 cases (15.3%) within and after 3 weeks after surgery, respectively. PROM was significantly

2008 American Journal of Obstetrics and Gynecology

2609. Environmental contaminants and pregnancy outcomes. (Abstract)

to consider in studies of environmental exposures, such as young or old maternal age, race/ethnicity, multiple births, low socioeconomic status, inadequate prenatal care, low maternal weight gain, and infections and premature rupture of the membranes. Environmental contaminants found associated with increased risk of one or more of the endpoints include: tobacco smoke, carbon monoxide, air pollutants, heavy metals, pesticides, chlorination byproducts, and solvents.Future research directions include (...) Environmental contaminants and pregnancy outcomes. To review selected environmental, occupational, and other important risk factors for the following adverse pregnancy outcomes: low birth weight (LBW), intrauterine growth retardation (IUGR), and preterm delivery (PTD).The evidence is explored in greater detail for environmental tobacco smoke, drinking water disinfection byproducts, and organochlorine (DDT) and organophosphate pesticides, partly using a weight of evidence approach.Low birth

2008 Fertility and Sterility

2610. Using Proteomic Analysis of the Human Amniotic Fluid to Identify Histologic Chorioamnionitis. (Abstract)

Using Proteomic Analysis of the Human Amniotic Fluid to Identify Histologic Chorioamnionitis. To estimate the relationship between histologic chorioamnionitis and four amniotic fluid proteomic biomarkers characteristic of inflammation (defensins 2 and 1, calgranulins C and A).One hundred fifty-eight women with singleton pregnancies had a clinically indicated amniocentesis to rule out inflammation and infection in the context of preterm labor or preterm premature rupture of membranes

2008 Obstetrics and Gynecology

2611. Carriage of group B streptococcus in pregnant women from Oxford, UK. Full Text available with Trip Pro

(n = 167) of the pregnant women participating were examined.21.3% were colonised vagino-rectally with GBS. Risk factors for neonatal GBS disease (maternal fever, prolonged rupture of membranes, and preterm delivery) were present in 34 of 167 women (20.4%), and the presence of these factors correlated poorly with GBS carriage. Capsular serotypes III (26.4%), IA (25.8%), V (18.9%), and IB (15.7%) were prevalent in the GBS isolates. Selective broth culture of vagino-rectal swabs was superior

2006 Journal of Clinical Pathology

2612. Age and uterine receptiveness: predicting the outcome of oocyte donation cycles. Full Text available with Trip Pro

is significantly increased from 45 yr of age onward. Concerning obstetric outcome, incidences of hypertension, proteinuria, premature rupture of membranes, second- and third-trimester hemorrhage, and preterm delivery are higher and mean birth weight is lower in this age group. With regard to endometrial preparation, estrogen therapy lasting more than 7 wk is associated with reduced PR and IR (P = 0.01 and P = 0.02, respectively).The results of OD cycles and obstetric outcome are significantly worse when

2005 Journal of Clinical Endocrinology and Metabolism

2613. Association of gastric fluid microbes at birth with severe bronchopulmonary dysplasia. (Abstract)

had positive gastric fluid specimens. Compared to infants negative for gastric fluid microbes, infants positive for microbes had higher rates of maternal chorioamnionitis (18% vs 78%), premature rupture of membranes (11% vs 55%), severe bronchopulmonary dysplasia (1.6% vs 14%) and showed higher plasma KL-6 levels during the initial 4 weeks of life.Detection of gastric fluid microbes was correlated well with antenatal infection and severe bronchopulmonary dysplasia. Detection of Ureaplasma species (...) Association of gastric fluid microbes at birth with severe bronchopulmonary dysplasia. Gastric fluid microbes were examined in preterm infants at birth to assess their influence on the postnatal outcome.Prospective cohort study.Level III neonatal intensive care unit.A total of 103 premature neonates with a gestational age of less than 32 weeks.Gastric fluid microbes were identified by analysis of bacterial 16S ribosomal RNA gene. Additionally, the urease gene of Ureaplasma species was detected

2008 Archives of Disease in Childhood. Fetal and Neonatal Edition

2614. Uterine necrosis: a complication of uterine compression sutures. (Abstract)

Uterine necrosis: a complication of uterine compression sutures. In cases of uterine atony, uterine compression sutures work by applying direct uterine compression.A 33-year-old gravida 2, para 0101 with preterm premature rupture of the membranes at 31 and 4/7 weeks of gestation underwent cesarean delivery. Because of significant uterine atony, two uterine compression sutures were placed. On postoperative day 8, the patient returned to the operating room secondary to persistent fevers

2008 Obstetrics and Gynecology

2615. Pregnancy outcomes in young women with perinatally acquired human immunodeficiency virus-1. (Abstract)

immunodeficiency virus (HIV) status were abstracted.The median age at first pregnancy was 18.5 years and 70% were African American. The most common comorbidities were hematologic abnormalities (70%) and cervical dysplasia/sexually transmitted infections (STIs) (80%). Initial median CD4 and viral load were 317 cells/mm(3) and 8780 copies/mL, respectively. The median gestational age at delivery was 38 weeks. The most common obstetrical complications were preeclampsia (23%) and premature rupture of membranes (...) /preterm delivery (31%). The cesarean delivery (CD) rate was 62%, with HIV as the indication in 75%. All infants were born alive; 1 was HIV infected.Despite high rates of STIs, CD, preterm delivery, and hypertensive disorders, perinatal outcomes were favorable.

2008 American Journal of Obstetrics and Gynecology

2616. Total hemoglobin concentration in amniotic fluid is increased in intraamniotic infection/inflammation. Full Text available with Trip Pro

labor (term and preterm), and the presence or absence of IAI.This cross-sectional study included patients in the following groups: (1) mid trimester (n = 65 patients); (2) term not in labor (n = 22 patients); (3) term in labor (n = 47 patients); (4) spontaneous PTL who delivered at term (n = 92 patients); (5) PTL without IAI who delivered preterm (n = 76 patients); (6) PTL with IAI (n = 81 patients); (7) preterm prelabor rupture of the membranes (PPROM) with IAI (n = 48 patients); and (8) PPROM (...) Total hemoglobin concentration in amniotic fluid is increased in intraamniotic infection/inflammation. Discolored amniotic fluid (AF) has been associated with intraamniotic infection/inflammation (IAI) in patients with preterm labor (PTL). The presence of hemoglobin and its catabolic products has been implicated as a cause for AF discoloration. The aim of this study was to determine whether there is an association between total hemoglobin concentration in AF and gestational age, spontaneous

2008 American Journal of Obstetrics and Gynecology

2617. Contemporary practice patterns and beliefs regarding tocolysis among u.s. Maternal-fetal medicine specialists. (Abstract)

tocolysis after arrested preterm labor; 3) repeat acute preterm labor; 4) preterm premature rupture of membranes (PROM) without contractions; and 5) preterm PROM with contractions.A total of 827 (46%) SMFM members responded. Ninety-six percent, 56%, 56%, 32%, and 29% would recommend tocolysis for acute preterm labor, repeat acute preterm labor, preterm PROM with contractions, preterm PROM without contractions, and maintenance tocolysis, respectively. The most common first-line tocolytic was magnesium (...) Contemporary practice patterns and beliefs regarding tocolysis among u.s. Maternal-fetal medicine specialists. To estimate maternal-fetal medicine specialists' practice patterns and perceived risks and benefits to tocolysis.We performed a mail-based survey of all Society for Maternal-Fetal Medicine (SMFM) members in the United States. Subjects were asked whether they would recommend tocolysis and what would be their first-line tocolytic in five scenarios: 1) acute preterm labor; 2) maintenance

2008 Obstetrics and Gynecology

2618. ABO phenotype and other risk factors associated with chorioamnionitis. (Abstract)

(blood types B and AB). Univariate, bivariate, and logistic regression analyses were done to examine risk factors for chorioamnionitis while controlling for confounders.The study included 2879 subjects, 96 of whom (3.3%) were diagnosed with chorioamnionitis. Chorioamnionitis increased significantly with alcohol use (adjusted odds ratio [AOR] = 4.7), prolonged rupture of membranes (ROM) (AOR = 4.16), anemia (AOR = 2.17), and group 1 status (AOR = 1.88). Advanced maternal age was protective (...) ABO phenotype and other risk factors associated with chorioamnionitis. To examine risk factors associated with chorioamnionitis.We conducted a retrospective cohort study using data on women who delivered prematurely (< 37 weeks of gestation) over a 12-year period. Eleven potential risk factors were identified. Subjects were stratified according to their blood type into 2 groups: group 1, subjects with anti-B antibodies (blood types A and O), and group 2, subjects without anti-B antibodies

2008 Journal of Pediatrics

2619. Pregnancy management after cervical surgery. (Abstract)

Pregnancy management after cervical surgery. An amplified risk of adverse pregnancy outcomes after excisional cervical surgery has been identified. Procedures such as cold-knife conization, laser conization, loop electrosurgical excision procedure, and trachelectomy increase the risk of preterm delivery and preterm premature rupture of membranes. Few studies have evaluated prenatal care considerations after these procedures. This review discusses pregnancy management after cervical surgery.Data (...) showing an association between excisional and ablative procedures of the cervix and subsequent preterm delivery or preterm premature rupture of membranes are increasing and include more recent information from larger case series and meta-analyses. The need for appropriate and evidence-based management strategies during subsequent pregnancy has arisen. Screening for genital tract infection, sonographic cervical length surveillance, and progesterone administration for cervical shortening may lead

2008 Current Opinion in Obstetrics and Gynecology

2620. Quantification of Ureaplasma urealyticum DNA in the amniotic fluid from patients in PTL and pPROM and its relation to inflammatory cytokine levels. (Abstract)

Quantification of Ureaplasma urealyticum DNA in the amniotic fluid from patients in PTL and pPROM and its relation to inflammatory cytokine levels. To study the effect of the amniotic fluid quantity of Ureaplasma urealyticum DNA on inflammatory response levels in women with preterm labor (PTL) and preterm prelabor rupture of membranes (pPROM).A prospective multi-center follow up study.Sahlgrenska University Hospital, Goteborg, Sweden and Turku University Hospital, Turku, Finland.Eleven U

2008 Acta Obstetricia et Gynecologica Scandinavica

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