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Premature Rupture of Membranes

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2661. Total hemoglobin concentration in amniotic fluid is increased in intraamniotic infection/inflammation. (Full text)

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 PubMed abstract

2662. Risk factors for periventricular leukomalacia. (Abstract)

type I (RDS I), seizures, sepsis, required more days of both mechanical ventilation and oxygen administration, while the duration of their hospitalization was longer compared to controls. Also, they were born more frequently to mothers who suffered from preterm premature rupture of membranes (PPROM) and clinical chorioamnionitis. We found that male gender, PPROM, preeclampsia, hypocarbia and IVH were independently associated with PVL.This study revealed that preterm neonates born to mothers

2008 Acta Obstetricia et Gynecologica Scandinavica

2663. 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

2664. 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

2665. 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

2666. 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

2667. Pregnancy after radical trachelectomy: a real option? (Abstract)

who tried to conceive after radical trachelectomy succeeded once or more than once (70%). Patients attempting to conceive need to be informed of the complications and risk factors, in particular, second trimester loss and premature delivery caused by premature rupture of membranes. Once pregnant, patients need to be carefully followed for cervical incompetence and other risk factors for premature rupture of membranes. (...) % of the patients who tried to conceive, cervical stenosis was found and resulted in menstrual disorders or fertility problems. Surgical dilatation resolved this problem in most cases but had to be repeated. Complications during pregnancy involved second trimester loss (13/161) and premature (< or =36 weeks AD) delivery (33/161).Pregnancy after radical trachelectomy is feasible. For various reasons, a number of patients (57%) did not try to get pregnant after the surgical procedure. The majority of the patients

2005 Gynecologic Oncology

2668. Risk of complications during pregnancy after Senning or Mustard (atrial) repair of complete transposition of the great arteries. (Full text)

and three elective abortions. During 39 of the 49 completed pregnancies, complications were observed. The most important cardiac complication was clinically significant arrhythmia (n=11, 22%), especially occurring in patients with a prior history of arrhythmia. Important general pregnancy complications were preeclampsia (n=5, 10.2%) and pregnancy-induced hypertension (n=4, 8.2%). Obstetric complications included premature rupture of membranes (n=7, 14.3%), premature labour (n=12, 24.4%), premature

2005 European Heart Journal PubMed abstract

2669. Delivery outcome after cold-knife conization of the uterine cervix. (Abstract)

) of the conization group and in 6.6% (n = 1961) of the controls (OR = 4.07 [2.22-7.10], P < 0.001). Preterm premature rupture of the membranes was found in 17.1% (n = 13) of the conization group and in 2.6% (n = 775) of the controls (OR = 7.70 [3.87-14.21], P < 0.001). Birth weight less than 2500 g was found in 18.4% (n = 14) of the conization group and in 7.7% (n = 2280) of the controls (OR = 2.72 [1.40-4.92], P = 0.002). Overall, birth weight in the conization group was not significantly lower (median 3147 g (...) vs. 3287 g, P = 0.115). Cervical tears were found more frequently in the conization group (8.8% [n = 6] vs. 1.3% [n = 236], OR = 7.53 [2.63-17.57], P < 0.001). There was no difference in mode of delivery, duration of labor, head circumference, chorioamnionitis and use of oxytocin.Cold-knife conization is a risk factor for preterm birth and preterm premature rupture of the membranes and seems to be a risk factor for cervical tears.

2006 Gynecologic Oncology

2670. Pregnancy and delivery in women after Fontan palliation. (Full text)

five miscarriages (50%) and one aborted ectopic pregnancy. During the remaining four live-birth pregnancies clinically significant complications were encountered: New York Heart Association class deterioration; atrial fibrillation; gestational hypertension; premature rupture of membranes; premature delivery; fetal growth retardation and neonatal death. Four of seven women who had attempted to become pregnant reported female infertility: non-specified secondary infertility (n = 2), uterus bicornis

2006 Heart PubMed abstract

2671. Age and uterine receptiveness: predicting the outcome of oocyte donation cycles. (Full text)

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 PubMed abstract

2672. Obstetric hospitalizations in the United States for women with systemic lupus erythematosus and rheumatoid arthritis. (Abstract)

to estimate the number of obstetric hospitalizations, deliveries, and cesarean deliveries in women with SLE, RA, pregestational DM, and the general obstetric population. Pregnancy outcomes included length of hospital stay, hypertensive disorders including preeclampsia, premature rupture of membranes, and intrauterine growth restriction.Of an estimated 4.04 million deliveries, 3,264 occurred in women with SLE, 1,425 in women with RA, and 13,574 in women with pregestational DM. Women with SLE, RA

2006 Arthritis and Rheumatism

2673. Could a cervical occlusion suture be effective at improving perinatal outcome? (Abstract)

, which can lead to chorioamnionitis and rupture of the amniotic membranes. In this review, we examine the background of traditional cervical cerclage and introduce the concept of the occlusion suture and its potential benefit in reducing the risk of recurrent preterm prelabour rupture of membranes. (...) Could a cervical occlusion suture be effective at improving perinatal outcome? Cervical weakness and infection have long been regarded as major causes of preterm birth. Cervical cerclage has been used extensively to reduce the risk of preterm birth arising as a result of cervical weakness, but increasing evidence suggests that the cervix plays more than just a mechanical role. Immunological function of the cervix and mucus plug is thought to be important in minimising the ingress of microbes

2007 BJOG

2674. Impact and risk factors for early-onset group B streptococcal morbidity: analysis of a national, population-based cohort in Sweden 1997-2001. (Abstract)

, respectively. The mortality was 7.5, 0.7, and 2.2% in respective groups. The frequencies of established maternal risk factors were: membrane rupture > or =18 hours, 44%; prematurity, 26%; temperature during labour > or =38 degrees C, 22%. Novel maternal risk factors identified in verified cases were gestational age (GA) of 37 completed weeks (OR 3.5, 1.8-6.5) and gestational diabetes (OR 3.7, 1.8-8.5). When including clinical sepsis, also epidural anaesthesia, infant large for GA, postmaturity, and high

2006 BJOG

2675. Prenatal intervention for isolated congenital diaphragmatic hernia. (Abstract)

occlusion increased lung size as well as survival, with an early (7 day) survival, late neonatal (28 day) survival and survival at discharge of 75, 58 and 50%, respectively, comparing favorably with 9% in contemporary controls. Airways can be restored prior to birth improving neonatal survival (83.3% compared with 33.3%). The procedure carries a risk for preterm prelabour rupture of the fetal membranes, although that may decrease with experience.Fetuses with severe congenital diaphragmatic hernia can

2006 Current Opinion in Obstetrics and Gynecology

2676. Recent findings on laser treatment of twin-to-twin transfusion syndrome. (Abstract)

Recent findings on laser treatment of twin-to-twin transfusion syndrome. Despite the recent demonstration of the benefit of the primary laser over amnioreduction, overall survival is far from optimal (70-80%), and therefore diagnosis and management of early and late complications following placental surgery became of great importance.Laser therapy has proven to be better than amnioreduction in treating twin-to-twin transfusion syndrome. Miscarriage, preterm premature rupture of the membranes (...) and preterm delivery account for more than 20% of perinatal mortality after treatment. In those who die despite treatment, recurrence of twin-to-twin transfusion syndrome, placental insufficiency or feto-fetal hemorrhage with anemia/polycythemia are complications that have to be managed with different secondary therapeutic options, such as amnioreduction, cord coagulation, intrauterine transfusion or repeat fetoscopy-guided laser. Ex-vivo placental angiography has confirmed that these complications occur

2006 Current Opinion in Obstetrics and Gynecology

2677. Increased risk in the elderly parturient. (Abstract)

, multiple gestation, prelabour rupture of membranes, and preterm labour. Intrapartum complications of malpresentation, fetopelvic disproportion, abnormal labour, increased use of oxytocin in labour, caesarean section, instrumental delivery, sphincter rupture, and postpartum haemorrhage are more frequent in older women. Advanced maternal age is associated with a higher risk of stillbirth throughout gestation, and the peak risk period is 37-41 weeks. Perinatal outcomes differ with maternal age concerning (...) gestational age, birth weight, prematurity, low birth weight, incidence of small-for-gestational-age infants, fetal distress, and perinatal morbidity and mortality. The increased risk cannot be explained only by intercurrent illness or pregnancy complications.Increasing maternal age is independently associated with specific adverse outcomes. Increasing age is a continuum rather than threshold effect. More information about obstetric consequences of delayed childbearing is needed both for obstetricians

2007 Current Opinion in Obstetrics and Gynecology

2678. Procedure-related complications of rapid amniodrainage in the treatment of polyhydramnios. (Abstract)

(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

2679. Accuracy of sonographically estimated fetal weight in 840 women with different pregnancy complications prior to induction of labor. (Abstract)

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

2680. Umbilical cord occlusion of the donor versus recipient fetus in twin-twin transfusion syndrome. (Abstract)

at delivery (34.8 vs. 33.8 weeks) and preterm premature rupture of membranes rate (16.6% vs. 15.7%) whether the donor or recipient twin, respectively, was the subject of UCO. However, two-trocar access (50% vs. 5.3%; P = 0.03) and amnioinfusion (83.3% vs. 0%; P < 0.001) were required more often in the UCO of the donor than of the recipient twin, respectively. Operating time (75 vs. 40 min) was significantly longer in UCO of the donor twin (P = 0.04). UCP was more likely to be used in occlusion

2004 Ultrasound in Obstetrics and Gynecology

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