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Premature Rupture of Membranes

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2901. Antibiotic administration to patients with preterm labor and intact membranes: is there a beneficial effect in patients with endocervical inflammation? Full Text available with Trip Pro

in which women in premature labor were alternately allocated to receive either antibiotics or placebo, and information about MIAC and ECI collected. Eighty-four pregnant women between 24 and 34 weeks of gestation with spontaneous preterm labor were enrolled. Exclusion criteria were cervical dilatation greater than 3 cm, clinical chorioamnionitis, abruption, rupture of membranes, vaginal bleeding, and several additional fetal and maternal conditions that may influence perinatal outcome. Amniocentesis (...) Antibiotic administration to patients with preterm labor and intact membranes: is there a beneficial effect in patients with endocervical inflammation? To determine whether broad-spectrum antibiotic administration to patients with preterm labor and intact membranes is associated with an improvement in neonatal and maternal outcomes, particularly in patients with microbial invasion of the amniotic cavity (MIAC) or endocervical inflammation (ECI).A prospective clinical trial was conducted

2006 The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians

2902. Toll-like receptor-2 and -4 in the chorioamniotic membranes in spontaneous labor at term and in preterm parturition that are associated with chorioamnionitis. (Abstract)

transcriptase-polymerase chain reaction were used to examine the chorioamnion from patients with (1) preterm labor and intact membranes, (2) preterm premature rupture of membranes who were delivered < or =34 weeks of gestation, and (3) women at term with or without labor. All groups were stratified on the basis of the presence of histologic chorioamnionitis.Toll-like receptor-2 expression was significantly higher in patients with chorioamnionitis than in patients without this condition (all P < .05 (...) Toll-like receptor-2 and -4 in the chorioamniotic membranes in spontaneous labor at term and in preterm parturition that are associated with chorioamnionitis. The Toll-like receptor-2 and -4 recognize microbial products that are associated with gram-positive and gram-negative bacteria, respectively. This study examined Toll-like receptor-2 and -4 expression in fetal membranes in response to labor at term and histologic chorioamnionitis.Immunohistochemistry and real-time quantitative reverse

2004 American Journal of Obstetrics and Gynecology

2903. Racial disparity in membrane response to infectious stimuli: a possible explanation for observed differences in the incidence of prematurity. Community Award Paper. (Abstract)

in the AA group-derived membranes after stimulation. No change in MMP9 concentration was seen after stimulation of the C group-derived membranes.Although the C group produced more TNF, they also produce higher sTNFRs, which may serve a protective role. The increased MMP9 release by the AA group may be suggestive of the greater risk of premature rupture of membranes in the AA group. (...) Racial disparity in membrane response to infectious stimuli: a possible explanation for observed differences in the incidence of prematurity. Community Award Paper. This study compares the immune responsiveness of amniochorionic membranes (AC) derived from African American (AA) and white (C) women to an infectious stimulus ex vivo.AC derived from AA and C women were placed in an organ explant culture for 48 hours and then stimulated with endotoxin. Enzyme-linked immunosorbent assay measured

2004 American Journal of Obstetrics and Gynecology

2904. Sonographic cervical length in singleton pregnancies with intact membranes presenting with threatened preterm labor. (Abstract)

Sonographic cervical length in singleton pregnancies with intact membranes presenting with threatened preterm labor. Less than 10% of women presenting with preterm contractions progress to active labor and delivery. This study investigates whether cervical length measurements by ultrasound can discriminate between true and false labor in women presenting with threatened preterm labor.Cervical length was measured by transvaginal ultrasound in 253 women with singleton pregnancies presenting (...) with painful uterine contractions at a median age of 31 (range, 24-35) weeks of gestation. Women presenting in active labor, defined by the presence of cervical dilatation of >or = 3 cm, those with ruptured membranes and those that underwent prior or subsequent cervical cerclage were excluded from the study. The clinical management was determined by the attending obstetrician without taking into account the cervical length. Primary outcome of the study was delivery within 7 days of presentation based

2004 Ultrasound in Obstetrics and Gynecology

2905. Bacteria and inflammatory cells in fetal membranes do not always cause preterm labor. Full Text available with Trip Pro

and unreliable process, so the aim of this study was to harness modern molecular techniques to detect organisms in tissues from human pregnancy. A DNA probe specific for conserved regions of bacterial 16S ribosomal RNA sequence was designed and labeled with fluorescein for fluorescence in situ hybridization. Organisms were detected in the great majority (>80%) of fetal membranes after prolonged premature rupture of the fetal membranes and after preterm labor, which was consistent with previous data (...) Bacteria and inflammatory cells in fetal membranes do not always cause preterm labor. Intrauterine infection has been frequently linked with preterm labor before 30 wk of human pregnancy. Many different species of organisms have been detected, leading to the suggestion that infection-induced preterm labor is a generic inflammatory response to organisms rather than a specific response to a limited number of pathogens. The detection of organisms by microbiological culture is a laborious

2005 Pediatric Research

2906. Concomitant use of glucocorticoids: a comparison of two metaanalyses on antibiotic treatment in preterm premature rupture of membranes

Concomitant use of glucocorticoids: a comparison of two metaanalyses on antibiotic treatment in preterm premature rupture of membranes Concomitant use of glucocorticoids: a comparison of two metaanalyses on antibiotic treatment in preterm premature rupture of membranes Concomitant use of glucocorticoids: a comparison of two metaanalyses on antibiotic treatment in preterm premature rupture of membranes Leitich H, Egarter C, Reisenberger K, Kaider A, Berghammer P Authors' objectives (...) To investigate whether the demonstrated beneficial effects of antibiotics on maternal and neonatal morbidity are altered when glucocorticoids are part of the treatment of pre-term premature rupture of membranes. Searching The authors searched 18 medical databases, including MEDLINE (from 1966 to October 1996) and EMBASE (from 1974 to October 1996). The search terms were: 'preterm' or 'preterm premature rupture', 'amniotic' or 'fetal/foetal membrane', 'amnion' or 'amniotic sac', and 'antibiotic

1998 DARE.

2907. A meta-analysis of the use of corticosteroids in pregnancies complicated by preterm premature rupture of membranes

A meta-analysis of the use of corticosteroids in pregnancies complicated by preterm premature rupture of membranes A meta-analysis of the use of corticosteroids in pregnancies complicated by preterm premature rupture of membranes A meta-analysis of the use of corticosteroids in pregnancies complicated by preterm premature rupture of membranes Pattinson R C Authors' objectives To assess the use of corticosteroids in pregnancies complicated by preterm premature rupture of membranes (PPROM (...) in the intervention groups and placebo with or without concomitant use of antibiotics in the control groups. Participants included in the review Pregnant women with preterm premature rupture of membranes. Outcomes assessed in the review The effect of corticosteriods on maternal infection (chorio- amnionitis and endometritis) and neonatal outcome (respiratory distress, necrotising enterocolitis, neonatal infection and perinatal death). How were decisions on the relevance of primary studies made? The author does

1999 DARE.

2908. Antimicrobial therapy in expectant management of preterm premature rupture of the membranes

Antimicrobial therapy in expectant management of preterm premature rupture of the membranes Antimicrobial therapy in expectant management of preterm premature rupture of the membranes Antimicrobial therapy in expectant management of preterm premature rupture of the membranes Mercer B M, Arheart K L Authors' objectives To assess the impact of antimicrobial treatment on maternal and foetal outcomes during expectant management of pre-term premature rupture of the membranes. Searching MEDLINE (...) although some questions remain unanswered because of the low power of some comparisons. Bibliographic details Mercer B M, Arheart K L. Antimicrobial therapy in expectant management of preterm premature rupture of the membranes. Lancet 1995; 346: 1271-1279 PubMedID Indexing Status Subject indexing assigned by NLM MeSH Anti-Bacterial Agents /therapeutic use; Bacterial Infections /diagnosis; Bias (Epidemiology); Ceftizoxime /therapeutic use; Cerebral Hemorrhage /diagnosis; Chemoprevention

1995 DARE.

2909. Utility of antibiotic therapy in preterm premature rupture of membranes: a meta-analysis

Utility of antibiotic therapy in preterm premature rupture of membranes: a meta-analysis Utility of antibiotic therapy in preterm premature rupture of membranes: a meta-analysis Utility of antibiotic therapy in preterm premature rupture of membranes: a meta-analysis Ananth C V, Guise J M, Thorp J M Authors' objectives To examine the efficacy and effectiveness of antibiotic therapy on maternal outcomes in pre-term premature rupture of membranes (PROM) in pregnancy. Searching The following (...) studies, although only placebo-controlled RCTs were included. Heterogeneity tests were performed but not discussed. Bibliographic details Ananth C V, Guise J M, Thorp J M. Utility of antibiotic therapy in preterm premature rupture of membranes: a meta-analysis. Obstetrical and Gynecological Survey 1996; 51(5): 324-328 PubMedID Indexing Status Subject indexing assigned by NLM MeSH Anti-Bacterial Agents /therapeutic use; Female; Fetal Membranes, Premature Rupture /drug therapy; Humans; Pregnancy

1996 DARE.

2910. Antibiotic treatment in preterm premature rupture of membranes and neonatal morbidity: a metaanalysis

Antibiotic treatment in preterm premature rupture of membranes and neonatal morbidity: a metaanalysis Antibiotic treatment in preterm premature rupture of membranes and neonatal morbidity: a metaanalysis Antibiotic treatment in preterm premature rupture of membranes and neonatal morbidity: a metaanalysis Egarter C, Leitich H, Karas H, Wieser F, Husslein P, Kaider A, Schemper M Authors' objectives To assess the effect of prophylactic antibiotics on neonatal mortality, clinical sepsis (...) of the neonate, respiratory distress syndrome (RDS), intraventricular haemorrhage (IVH), and necrotising enterocolitis (NEC) in mothers with pre-term premature rupture of membranes. Searching MEDLINE was searched from 1966 to January 1995, and EMBASE from 1974 to January 1995, for all literature included under the following terms: 'preterm' or 'premature rupture', 'amniotic' or 'fetal' or 'fetal membrane', 'amnion' or 'amniotic sac', and 'antibiotics'. Study selection Study designs of evaluations included

1996 DARE.

2911. Cost-effectiveness of induction after preterm premature rupture of the membranes

Cost-effectiveness of induction after preterm premature rupture of the membranes Cost-effectiveness of induction after preterm premature rupture of the membranes Cost-effectiveness of induction after preterm premature rupture of the membranes Grable I A Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment (...) on the reliability of the study and the conclusions drawn. Health technology A protocol for the management of induction after preterm premature rupture of the membranes (PPROM) between 32 and 36 weeks' gestation was examined. The protocol was immediate delivery or prolonged gestation. Type of intervention Treatment. Economic study type Cost-effectiveness analysis. Study population The study population comprised a hypothetical cohort of patients with PPROM between 32 and 36 weeks' gestation. Setting The setting

2002 NHS Economic Evaluation Database.

2912. Foley Catheter for Labor Induction in Women With Term and Near Term Membrane Rupture

to delivery. Condition or disease Intervention/treatment Phase Fetal Membranes, Premature Rupture Labor, Induced/IS Device: Transcervical Foley catheter Not Applicable Detailed Description: To compare the efficacy of a transcervical Foley catheter with concurrent oxytocin administration compared to oxytocin infusion alone for cervical ripening and labor induction in women with premature rupture of membranes (PROM) at > 34 weeks. Study Design Go to Layout table for study information Study Type (...) for eligibility information Ages Eligible for Study: 12 Years to 55 Years (Child, Adult) Sexes Eligible for Study: Female Accepts Healthy Volunteers: No Criteria Inclusion Criteria: Preterm rupture of membranes (PROM) (Rupture of membranes = pooling/ferning/nitrazine +) Rupture of membranes (ROM) for ≥1 hour prior to starting induction Cervix ≤ 2 centimeters (cm) Gestational age ≥ 34 weeks by best obstetric estimate and clinical management decision is delivery Singleton gestation Cephalic Vertex well applied

2006 Clinical Trials

2913. The role of matrix degrading enzymes and apoptosis in rupture of membranes. (Abstract)

The role of matrix degrading enzymes and apoptosis in rupture of membranes. Prematurity is the third leading cause of perinatal death, and preterm premature rupture of the membranes (pPROM) is associated with approximately 20-50% of all preterm births. The etiologic factors described for pPROM and preterm labor (PTL) are the same, although the clinical presentation (pPROM vs PTL) differs among patients. The reason for this disparity is unknown and poses a therapeutic dilemma. Several etiologic (...) factors have been described for PTL and pPROM. PTL and pPROM are associated with overwhelming host inflammatory response. Many of these pro-inflammatory factors (inflammatory cytokine release) are common in both conditions; however, the clinical presentation differs. The objective of this review is to explain the differential expression pattern of matrix metalloproteinases (MMPs) and pro-apoptotic elements in human fetal membranes in pPROM and PTL and how they interact to present different clinical

2004 Journal of the Society for Gynecologic Investigation

2914. Prediction of labor and delivery by transperineal ultrasound in pregnancies with prelabor rupture of membranes at term. (Abstract)

Prediction of labor and delivery by transperineal ultrasound in pregnancies with prelabor rupture of membranes at term. To evaluate whether engagement of the fetal head or cervical length in women with premature rupture of membranes (PROM) at term, are associated with time from PROM to delivery or need for operative delivery.A transperineal ultrasound examination was performed in 152 women with a single live fetus in cephalic presentation after PROM (at > 37 gestational weeks). The shortest

2006 Ultrasound in Obstetrics and Gynecology

2915. The physiology of fetal membrane rupture: insight gained from the determination of physical properties. (Abstract)

The physiology of fetal membrane rupture: insight gained from the determination of physical properties. Premature rupture of the fetal membranes is a major cause of preterm birth and its associated infant morbidity and mortality. Recently, it has become clear that rupture of the fetal membranes, term or preterm, is not merely the result of the stretch and shear forces of uterine contractions, but is, in significant part, the consequence of a programmed weakening process. Work in the rat model (...) collagen remodeling and apoptosis. These findings provide strong support for the concept of programmed fetal membrane weakening prior to labor. Our model has also been used to establish the physical properties of individual fetal membrane components (amnion, chorion), determine the sequence of events during the fetal membrane rupture process, and demonstrate that treatment of fetal membranes with TNF or IL-1beta, in vitro, induces weakness and the identical biochemical markers of collagen remodeling

2006 Placenta

2916. Prostaglandine E2 par voie vaginale dans les ruptures prematurees des membranes a terme avec col defavorable: meta-analyse [Vaginal administration prostaglandin E2 in premature ruptured membranes at term with an unfavorable cervix]

Prostaglandine E2 par voie vaginale dans les ruptures prematurees des membranes a terme avec col defavorable: meta-analyse [Vaginal administration prostaglandin E2 in premature ruptured membranes at term with an unfavorable cervix] Prostaglandine E2 par voie vaginale dans les ruptures prematurees des membranes a terme avec col defavorable: meta-analyse [Vaginal administration prostaglandin E2 in premature ruptured membranes at term with an unfavorable cervix] Prostaglandine E2 par voie vaginale (...) dans les ruptures prematurees des membranes a terme avec col defavorable: meta-analyse [Vaginal administration prostaglandin E2 in premature ruptured membranes at term with an unfavorable cervix] Carbonne B, Goffinet F, Cabrol D Authors' objectives To compare the immediate induction of labour using vaginal prostaglandins (PG) with either the immediate induction of labour using oxytocin, or expectant management, in women with premature rupture of the membranes at term. Searching MEDLINE

1996 DARE.

2917. Fetal membrane healing after spontaneous and iatrogenic membrane rupture: a review of current evidence. Full Text available with Trip Pro

Fetal membrane healing after spontaneous and iatrogenic membrane rupture: a review of current evidence. In view of the important protective role of the fetal membranes, wound sealing, tissue regeneration, or wound healing could be life saving in cases of preterm premature rupture of the membranes. Although many investigators are studying the causes of preterm premature rupture of membranes, the emphasis has not been on the wound healing capacity of the fetal membranes. In this review (...) , the relevant literature on the pathophysiologic condition that leads to preterm premature rupture of membranes will be summarized to emphasize a continuum of events between rupture and repair. We will present the current knowledge on fetal membrane wound healing and discuss the clinical implications of these findings. We will critically discuss recent experimental interventions in women to seal or heal the fetal membranes after preterm premature rupture of membranes.

2006 American Journal of Obstetrics and Gynecology

2918. Childhood outcomes after prescription of antibiotics to pregnant women with preterm rupture of the membranes: 7-year follow-up of the ORACLE I trial. Full Text available with Trip Pro

Childhood outcomes after prescription of antibiotics to pregnant women with preterm rupture of the membranes: 7-year follow-up of the ORACLE I trial. The ORACLE I trial compared the use of erythromycin and/or amoxicillin-clavulanate (co-amoxiclav) with that of placebo for women with preterm rupture of the membranes without overt signs of clinical infection, by use of a factorial randomised design. The aim of the present study--the ORACLE Children Study I--was to determine the long-term effects (...) to mothers who received no co-amoxiclav (645 [40.6%] of 1587 vs 604 [38.1%] of 1584; 1.11, 0.96-1.28). Neither antibiotic had a significant effect on the overall level of behavioural difficulties experienced, on specific medical conditions, or on the proportions of children achieving each level in reading, writing, or mathematics at key stage one.The prescription of antibiotics for women with preterm rupture of the membranes seems to have little effect on the health of children at 7 years of age.UK

2008 Lancet

2919. Antioxidant supplementation and premature rupture of the membranes: a planned secondary analysis Full Text available with Trip Pro

Antioxidant supplementation and premature rupture of the membranes: a planned secondary analysis The purpose of this study was to determine if antioxidant supplementation during pregnancy reduces the incidence of premature rupture of the membranes (PROM).A placebo-controlled, double-blind trial was conducted. PROM and preterm PROM (PPROM) were planned secondary outcomes of the trial. Women between 12(0/7) and 19(6/7) weeks of gestation and diagnosed to have chronic hypertension or a prior

2008 EvidenceUpdates Controlled trial quality: predicted high

2920. Antibiotic treatment of preterm labor with intact membranes: a multicenter, randomized, double-blinded, placebo-controlled trial. (Abstract)

delivery (< 37 weeks), frequency of preterm premature rupture of membranes, clinical chorioamnionitis, endometritis, and number of subsequent admissions for preterm labor. Similarly, no significant difference in neonatal outcomes could be detected between the two groups including respiratory distress syndrome, bronchopulmonary dysplasia, intraventricular hemorrhage, sepsis, and admission and duration of newborn intensive special care unit hospitalization.The results of this study do not support (...) Antibiotic treatment of preterm labor with intact membranes: a multicenter, randomized, double-blinded, placebo-controlled trial. Although an association between subclinical intrauterine infection and preterm birth is well established, there is conflicting evidence regarding the benefits of antibiotic administration to women in preterm labor with intact membranes. We attempted to determine the effect of ampicillin-amoxicillin and erythromycin treatment on prolongation of pregnancy, the rate

1993 American journal of obstetrics and gynecology Controlled trial quality: predicted high

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