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Premature Rupture of Membranes

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2741. Pregnancy following treatment of symptomatic myomas with laparoscopic bipolar coagulation of uterine vessels. (Abstract)

and after LBCUV (P = 0.002), but no significant difference in myoma volume when comparing post-partum size with post-LBCUV size (P = 0.269). Pregnancy outcomes included seven miscarriages in the first trimester and one premature rupture of membrane (PPROM). Although the other pregnancies were regarded as uncomplicated, only two women were delivered of normal neonates as the other seven pregnancies were terminated secondary to patient request.The pregnancy and term pregnancy rates in sexually active

2003 Human Reproduction

2742. Streptococcus bovis bacteremia and fetal death. (Abstract)

Streptococcus bovis bacteremia and fetal death. Preterm premature rupture of membranes leading to intraamniotic infection and fetal death may be due to unusual bacterial species.A young multipara presented at 24 weeks and 6 days' gestation with rupture of membranes of 2 days' duration. She was febrile and hypotensive. No fetal heart activity was noted. Antibiotics, fluid resuscitation, and oxytocin were begun with delivery of a 798-g stillborn fetus. Maternal and fetal cultures demonstrated

2002 Obstetrics and Gynecology

2743. Pregnancy after uterine artery embolization. (Abstract)

Pregnancy after uterine artery embolization. Uterine artery embolization is an increasingly popular alternative to hysterectomy and myomectomy as a treatment for uterine leiomyoma. Whether this procedure is safe for women desiring future fertility is controversial.A primigravida who had previously undergone uterine artery embolization had premature rupture of membranes at 24 weeks. She had a cesarean delivery at 28 weeks, which was followed by uterine atony requiring hysterectomy (...) . A primigravida who had previously undergone uterine artery embolization delivered appropriately grown dichorionic twins at 36 weeks. An analysis of the 50 published cases of pregnancy after uterine artery embolization revealed the following complications: malpresentation (17%), small for gestational age (7%), premature delivery (28%), cesarean delivery (58%), and postpartum hemorrhage (13%).Women who become pregnant after uterine artery embolization are at risk for malpresentation, preterm birth, cesarean

2002 Obstetrics and Gynecology

2744. Physical properties of the chorioamnion throughout gestation. (Abstract)

Physical properties of the chorioamnion throughout gestation. Our purpose was to assess the tensile strength of the chorioamnion at various gestational ages.Segments of chorioamnion were obtained from 35 patients delivered at gestational ages ranging from 17 to 41 weeks. Clinical information including gestational age, chorioamnionitis, premature rupture of membranes, and onset of labor was recorded. Tensile strength (grams to burst and deflection at rupture) was measured on 2 to 16 specimens (...) and therapies on membrane strength and may provide insight into spontaneous rupture of membranes.

2002 American Journal of Obstetrics and Gynecology

2745. Selective feticide in monochorionic twin pregnancies by ultrasound-guided umbilical cord occlusion. Full Text available with Trip Pro

had a congenital diaphragmatic hernia, and three acardiac twins). One procedure failed due to maternal hemorrhage following insertion of the trocar (both fetuses died after emergency Cesarean section). One cotwin died a few minutes after the procedure and one survivor died within the neonatal period. The mean gestational age at the time of the procedure was 24 weeks of gestation and the mean gestational age at delivery was 31.1 weeks. Premature rupture of membranes occurred in four cases. Eight

2003 Ultrasound in Obstetrics and Gynecology

2746. Pregnancy outcomes in patients after radical trachelectomy. (Abstract)

to conceive for a median of 11 months (range 1-85). There have been a total of 22 pregnancies in 18 patients (4 patients pregnant twice). Of the 22 pregnancies, 18 were viable, with 12 progressing to term and delivering by caesarean section. Preterm premature rupture of membranes was the primary cause of preterm delivery.This series confirms that pregnancy is a safe and realistic outcome for women undergoing radical trachelectomy for invasive carcinoma of the cervix. Given the apparently high incidence (...) of preterm premature rupture of membranes, these pregnancies should be managed as high risk.

2003 American Journal of Obstetrics and Gynecology

2747. Pregnancy outcome in spontaneous twins versus twins who were conceived through in vitro fertilization. (Abstract)

vitro fertilization twins were more likely to have preterm labor compared with control twins, with no difference in the incidences of pregnancy-induced hypertension, gestational diabetes mellitus, placenta previa, or preterm premature rupture of membranes between the two groups. The cesarean delivery rate was significantly higher in cases of twins who were conceived by in vitro fertilization (76.8% vs 58.0%, P=.026), despite a similar rate of elective cesarean delivery and the incidence of nonvertex (...) to the neonatal intensive care unit, respiratory distress syndrome, a need for mechanical ventilation, and pneumothorax in cases compared with control subjects.When compared with spontaneous twins, in vitro fertilization twins are more likely to be delivered by cesarean delivery and to have a higher incidence of preterm birth and prematurity-related respiratory complications with a longer nursery stay.

2003 American Journal of Obstetrics and Gynecology

2748. Interleukin-1 receptor antagonist gene polymorphism and multifetal pregnancy outcome. (Abstract)

allele 1 was more than twice as prevalent as the carriage of allele 2. Preterm premature rupture of membranes was observed in 12 of 24 pregnancies (50.0%) in which 2 fetuses tested positive for interleukin-1 receptor antagonist allele 2, as opposed to only 3 of 27 pregnancies (11.1%) in which 1 or neither fetus tested positive for interleukin-1 receptor antagonist allele 2 (P=.005). Similarly, 20 of 26 neonates (76.9%) with documented morbidity tested positive for interleukin-1 receptor antagonist (...) allele 2, as compared with 36 of 78 neonates (46.2%) without morbidity (P=.007). Fetal or maternal interleukin-1beta polymorphisms or maternal interleukin-1 receptor antagonist polymorphisms were unrelated to pregnancy outcome.Fetal carriage of interleukin-1 receptor antagonist allele 2 was associated with both preterm premature rupture of membranes and neonatal morbidity in women with multifetal pregnancies.

2003 American Journal of Obstetrics and Gynecology

2749. Relationship of prenatal care and perinatal morbidity in low-birth-weight infants. (Abstract)

. Women with NPC had more advanced cervical dilation (ACD) greater than 4 cm (ACD: 63% vs 39%) and more amnionitis on admission (2% vs 1%), Ppremature rupture of membranes, antepartum hemorrhage, amnionitis, and ACD. Controlling for other factors, NPC LBW (...) Relationship of prenatal care and perinatal morbidity in low-birth-weight infants. Lack of or no prenatal care (NPC) is associated with preterm birth (PTB) and low birth weight (LBW). Our purpose was to determine whether LBW infants delivered after NPC have worse outcomes than LBW infants with prenatal care (PC).Eight thousand sixty-five consecutive women delivered at six hospitals in Shelby County, Tenn, were evaluated regarding clinical characteristics and perinatal outcomes depending

2003 American Journal of Obstetrics and Gynecology

2750. Specialized prenatal care and maternal and infant outcomes in twin pregnancy. (Abstract)

education.Program Pregnancies were associated with improved pregnancy outcomes (preeclampsia, adjusted odds ratio [AOR] 0.41, 95% CI, 0.23-0.75; preterm premature rupture of membranes, AOR 0.35, 95% CI, 0.20-0.60; delivery <36 weeks, AOR 0.62, 95% CI, 0.43-0.89; low birth weight, AOR 0.42, 95% CI, 0.29-0.61), significantly longer gestations (+7.6 days), higher birth weights (+220 g), lower neonatal morbidity (retinopathy of prematurity, necrotizing enterocolitis, intraventricular hemorrhage, or ventilator

2003 American Journal of Obstetrics and Gynecology

2751. Is the incidence of fetal-to-maternal hemorrhage increased in patients with third-trimester bleeding? (Abstract)

by third trimester bleeding compared with three control groups.Pregnancies that were complicated by third-trimester bleeding, preterm premature rupture of the membranes, and preterm labor were identified prospectively on admission. A group of preterm patients with no complications was also collected prospectively. Patients with any history and/or clinical evidence of trauma were excluded. Kleihauer-Betke tests were performed with all patients, and the results were blinded until study completion. Sample (...) size calculations were performed to determine the minimum number of cases needed in each group.A total of 403 patients were collected during the study period: 91 patients had third-trimester bleeding, 101 patients had preterm premature rupture of the membranes, 116 patients had preterm labor, and 95 patients were in the no complication group. There was no statistical difference identified in the Kleihauer-Betke test results between any of the study groups.The incidence of fetal-to-maternal

2003 American Journal of Obstetrics and Gynecology

2752. Cytokines, prostaglandins and parturition--a review. (Abstract)

Cytokines, prostaglandins and parturition--a review. The elaboration of cytokines, chemokines and immunomodulatory proteins in the placenta and gestational membranes has been extensively investigated in the context of both normal and abnormal pregnancy and delivery. Patterns of expression of cytokines in the foetal membranes and decidua suggest that inflammatory activation occurs modestly with term labour, but much more robustly in preterm delivery, particularly in the presence of intrauterine (...) infection. Enhanced chemokine expression, particularly evident in deliveries with an infected amniotic cavity, is presumably responsible for recruiting infiltrating leukocytes into the membranes thereby amplifying the inflammatory process and hastening membrane rupture and delivery. Anti-inflammatory cytokines suppress inflammatory reactions in the placenta, but under some circumstances may act in a pro-inflammatory fashion in the membranes. Intracellular signalling by cytokines is modulated by proteins

2003 Placenta

2753. Utility of complete blood count and blood culture screening to diagnose neonatal sepsis in the asymptomatic at risk newborn. (Abstract)

Utility of complete blood count and blood culture screening to diagnose neonatal sepsis in the asymptomatic at risk newborn. In May 1996, the CDC recommended obtaining a complete blood count and blood culture (BC) from all asymptomatic "at risk" newborns; those > or =35 weeks gestation born to mothers with group B streptococcal vaginal colonization or those with maternal fever, premature rupture of membranes or previous infant with group B streptococcal disease; who did not receive adequate

2003 Pediatric Infectious Dsease Journal

2754. Lactosylceramide-induced apoptosis in primary amnion cells and amnion-derived WISH cells. (Abstract)

Lactosylceramide-induced apoptosis in primary amnion cells and amnion-derived WISH cells. Amnion apoptosis is part of a programmed process of fetal membrane remodeling leading to weakening and rupture. The apoptotic agent lactosylceramide is elevated in amniotic fluid of premature infants with rupture of membranes. We have shown that apoptosis in WISH cells, induced by staurosporine, cycloheximide, or actinomycin D, can be blocked by cyclooxygenase inhibitors, suggesting a relationship between

2002 Journal of the Society for Gynecologic Investigation

2755. European experience with a novel noninvasive sensor for intra-amniotic or extra-amniotic evaluation of fetal oxygen saturation. (Abstract)

European experience with a novel noninvasive sensor for intra-amniotic or extra-amniotic evaluation of fetal oxygen saturation. We evaluated the feasibility of a new instrument for continuous fetal pulse oximetry during labor. The measuring sensor can be placed on the fetal back before or after rupture of membranes.One hundred adult women who had completed 32 weeks of gestation and had an anticipated duration of labor greater than 30 minutes were included in the study. Patients with premature (...) rupture of membranes for 24 hours or more, low placental localization, placenta previa or abruption, vaginal bleeding, acute infection, polyhydramnios, oligohydramnios, or uterine or congenital abnormalities were excluded.All sensors were placed successfully. The mean continuous recording time was 276 minutes. Peripheral oxygen saturation as measured by pulse oximeter values were obtained during a median of 64.05% of the recording time. No chorioamnionitis or endometritis was noted.The new sensor

2003 Journal of the Society for Gynecologic Investigation

2756. Streptococcus pneumoniae infections in the neonate. (Abstract)

Streptococcus pneumoniae infections in the neonate. Streptococcus pneumoniae infections in the neonate (SPIN) are relatively unusual events (1%-11% of neonatal sepsis) but are associated with substantial morbidity and mortality. Previous reports suggest that invasive SPIN is associated with prolonged rupture of membranes, maternal colonization/illness, prematurity, early-onset pneumonia presentation (<72 hours), and high mortality (50%). The aim of this study was to review the current

2003 Pediatrics

2757. Early-onset group B streptococcal infection after a combined maternal and neonatal group B streptococcal chemoprophylaxis strategy. (Abstract)

and demographic data.There were 32 cases (0.47/1000 live births) of early-onset GBS infection for the 5-year period. This represented a 76% reduction compared with the rate from 1986 to 1994 (1.95/1000), when there was no protocol for GBS chemoprophylaxis. Thirteen cases (41%) did not have any identifiable maternal risk factor. Of the 19 cases (59%) with risk factors, maternal intrapartum fever was the most frequent (15 [79%]), followed by prematurity (6 [32%]) and prolonged rupture of membranes (6 [32

2003 Pediatrics

2758. Myasthenia gravis: consequences for pregnancy, delivery, and the newborn. (Abstract)

a higher rate of complications at delivery (40.9% vs 32.9%, p = 0.05), and in particular the risk of preterm rupture of amniotic membranes was three times higher in the MG group compared to the reference group (5.5% vs 1.7%, p = 0.001). The rate of interventions during birth was raised (33.9% vs 20.0%, p < 0.001) and cesarean sections doubled (17.3% vs 8.6%, p = 0.001). Five children (3.9%) born by MG mothers had severe anomalies, and three of them died.MG is associated with an increased risk

2003 Neurology

2759. Antenatal and perinatal strategies to prevent mother-to-child transmission of HIV infection. (Abstract)

and in the neonatal period, both in settings with and without breastfeeding. Elective caesarean section independently decreases the risk, but is not a safe and feasible option in most high prevalence areas. Birth canal cleansing with chlorhexidine does not reduce the rate overall, but may be beneficial in a subgroup of women with prolonged duration of ruptured membranes. Micronutrient supplementation, including vitamin A, does not reduce MTCT of HIV, but may improve pregnancy outcome generally. (...) , vaginal delivery, prematurity and breastfeeding. Approaches to reduce the risk of MTCT include reduction of maternal viral load through antiretroviral prophylaxis, avoidance of exposure through birth canal cleansing or elective caesarean section delivery and refraining from breastfeeding, and boosting the host immune system through nutritional supplementation or immunization. Substantial reductions in the risk of MTCT can be achieved with antiretroviral prophylaxis during pregnancy, delivery

2003 Transactions of the Royal Society of Tropical Medicine & Hygiene

2760. Women with impaired glucose tolerance during pregnancy have significantly poor pregnancy outcomes. (Abstract)

diagnostic criteria for GDM were used.Women with IGT were at increased risk for premature rupture of membranes (P-ROM) (odds ratio [OR] 10.07; 95% CI 2.90-34.93); preterm birth (6.42; 1.46-28.34); breech presentation (3.47; 1.11-10.84); and high birth weight (90th percentile or 4,000 g) (2.42; 1.07-5.46); adjusting for maternal age, pregravid BMI, hospital levels, and other confounding factors.The presence of IGT in pregnancy is predictive of poor pregnancy outcomes.

2002 Diabetes Care

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