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3,157 results for

Premature Rupture of Membranes

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3141. Decidual relaxins: gene and protein up-regulation in preterm premature rupture of the membranes by complementary DNA arrays and quantitative immunocytochemistry. (Abstract)

Decidual relaxins: gene and protein up-regulation in preterm premature rupture of the membranes by complementary DNA arrays and quantitative immunocytochemistry. This study was undertaken to show both decidual relaxin gene and protein up-regulation in preterm premature rupture of the fetal membranes.Membranes after preterm premature rupture (n = 4) have been matched in pairs with preterm intact membranes (n = 4). These tissues were from patients without infection, labor, preeclampsia (...) the region of least homologic features. The expression of five other genes that were selected from the arrays were quantitated by Northern analysis.Relaxin gene expression was up-regulated 3.4-fold on the complementary DNA arrays but was not confirmed on Northern analysis. On the other hand, protein analysis for relaxin H1 and H2 in the decidual cells showed them to be significantly up-regulated (P <.0001, for both proteins) in patients with preterm premature rupture of the membranes compared

2002 American Journal of Obstetrics and Gynecology

3142. Association of Lewis blood group phenotype with preterm premature rupture of membranes. (Abstract)

Association of Lewis blood group phenotype with preterm premature rupture of membranes. To evaluate the distribution of Lewis blood group phenotype and secretor status among women with preterm premature rupture of membranes.ABO and Lewis blood group phenotypes were determined in 20 consecutive women with preterm premature rupture of membranes. The control group was composed of 48 women from our database without known history of preterm delivery.Of the 20 patients with preterm premature rupture (...) of ABO and Lewis phenotype in the control group was similar to that in the general population. The proportion of combined recessive and nonsecretor phenotypes Le(a(+/-)b(-)) between patients with preterm premature rupture of membranes (17 of 20, 85%) and controls (11 of 48, 22.9%) was statistically significant (P <.001).Women with the Le(a(-)b(+)) phenotype who do secrete Le(b) antigen may have a protective effect against preterm premature rupture of membranes.

2003 Journal of the Society for Gynecologic Investigation

3143. Fetal plasma MMP-9 concentrations are elevated in preterm premature rupture of the membranes. (Abstract)

Fetal plasma MMP-9 concentrations are elevated in preterm premature rupture of the membranes. The objective of this study was to determine whether the concentrations of matrix metalloproteinase-9 (MMP-9) in the fetal (fetal plasma and amniotic fluid) and maternal compartments (plasma) are different in patients presenting with preterm premature rupture of membranes (PROM) than in those with preterm labor and intact membranes.Fetal plasma MMP-9, interleukin-1beta (IL-1beta), IL-6, soluble tumor (...) significantly higher in patients with preterm labor than in those with preterm PROM (IL-1beta, P =.01; sTNF-R1, P =.003; and sTNF-R2, P =.02). (3) The median amniotic fluid concentration of MMP-9 was higher in patients with preterm PROM than in those with preterm labor (P <.001).Fetuses with preterm PROM have increased concentrations of an enzyme (MMP-9) implicated in the mechanism of membrane rupture but lower concentrations of IL-1beta, sTNF-R1, and sTNF-R2 than fetuses with preterm labor and intact

2002 American Journal of Obstetrics and Gynecology

3144. Preterm premature rupture of membranes: vascular endothelial growth factor and its association with histologic chorioamnionitis. (Abstract)

Preterm premature rupture of membranes: vascular endothelial growth factor and its association with histologic chorioamnionitis. We hypothesize that vascular endothelial growth factor, a known angiogenic and permeability factor that is locally expressed in fetal membranes and decidua, may be the primary regulator in the pathway that eventually leads to preterm premature rupture of membranes. Our objective was to test the hypothesis that, both in the presence and in the absence of histologic (...) chorioamnionitis, there is an increased expression of the vascular endothelial growth factor gene and its receptor Flt-1 in the human fetal membranes.Membranes were sampled from a region that was distinct as the rupture site from three groups of patients with preterm premature rupture of membranes. Groups 1 and 2 differed only in the length of the latency period from rupture of the membranes to delivery. Group 3 included preterm patients with intact membranes, who acted as control subjects. All patients who

2002 American Journal of Obstetrics and Gynecology

3145. Failure of physiologic transformation of the spiral arteries in the placental bed in preterm premature rupture of membranes. (Abstract)

Failure of physiologic transformation of the spiral arteries in the placental bed in preterm premature rupture of membranes. The purpose of this study was to determine whether failure of physiologic transformation of the spiral arteries occurs in patients with preterm premature rupture of membranes (PROM).A cross-sectional study was designed to examine the histopathologic findings in the placental bed and placenta of patients with preterm PROM, preeclampsia, and normal women at term (...) . Immunohistochemistry with cytokeratin 7 and periodic acid-Schiff (PAS) were used to detect trophoblast and fibrinoid and to diagnose failure of physiologic transformation of the spiral arteries.One hundred thirteen cases met the inclusion criteria, 59 from patients with normal pregnancies, 31 with preterm PROM, and 23 with preeclampsia. The mean number of the spiral arteries with failure of physiologic transformation of the myometrial segment was significantly higher in patients with preterm PROM and preeclampsia

2002 American Journal of Obstetrics and Gynecology

3146. Perinatal outcome after preterm premature rupture of membranes with in situ cervical cerclage. (Abstract)

Perinatal outcome after preterm premature rupture of membranes with in situ cervical cerclage. The presence of a cervical cerclage at the time of preterm premature rupture of membranes (pPROM) could promote clinically evident infection and adverse pregnancy outcome. This cohort study examines whether the presence of cerclage at the time of pPROM is associated with increased maternal or neonatal inflammatory morbidity.All singleton pregnancies with cerclage and pPROM between 24.0 and 33.9 weeks (...) ' gestation at our institution (January 1985-December 1997) were reviewed. Controls (pPROM without cerclage) were matched 2.5:1 by year of presentation. Outcome measures suggest clinical evidence of an infectious response and include maternal admission white blood cell count, time to onset of preterm labor, clinical chorioamnionitis, postpartum fever, neonatal white-matter disease (intraventricular hemorrhage or periventricular leukomalacia) at less than 33 weeks, neonatal sepsis, and neonatal death.One

2002 American Journal of Obstetrics and Gynecology

3147. Cost-effectiveness of induction after preterm premature rupture of the membranes. (Abstract)

Cost-effectiveness of induction after preterm premature rupture of the membranes. Our purpose was to design a decision analytic model to evaluate the optimal length of time for expectant management after preterm premature rupture of the membranes between 32 and 36 weeks' gestation.Five models were created for 32 to 36 weeks' gestation. Probabilities for outcomes were obtained from medical center databases. Cost data were collected from the Health Care Microsystem database and were based on 1996 (...) dollars.The optimal time of delivery to minimize major morbidity was 34 to 36 weeks' gestation, depending on the time of rupture. When only major morbidity was considered, the most cost-effective approach between 32 to 34 weeks was to deliver 1 week after rupture. At 35 to 36 weeks, the most cost-effective approach was to deliver at presentation.The current method of treating all patients with ruptured membranes similarly and delivery at 34 weeks' gestation is not risk minimizing or cost-effective

2002 American Journal of Obstetrics and Gynecology

3148. Role of tumor necrosis factor-alpha in the premature rupture of membranes and preterm labor pathways. (Abstract)

Role of tumor necrosis factor-alpha in the premature rupture of membranes and preterm labor pathways. To further delineate the differences between the preterm labor and premature rupture of the membrane pathways, we investigated the role of the inflammatory cytokines as activators of matrix metalloproteinases 2 and 9 in human fetal membranes.Normal amniochorionic membrane that is maintained in an organ explant system was stimulated with interleukin-1beta, tumor necrosis factor-alpha

2002 American Journal of Obstetrics and Gynecology

3149. Preterm premature rupture of the membranes. (Abstract)

Preterm premature rupture of the membranes. Preterm premature rupture of membranes (PROM) affects over 120,000 pregnancies annually in the United States and is associated with significant maternal, fetal, and neonatal risk. Management of PROM requires an accurate diagnosis as well as evaluation of the risks and benefits of continued pregnancy or expeditious delivery. An understanding of gestational age-dependent neonatal morbidity and mortality is important in determining the potential benefits (...) of conservative management of preterm PROM at any gestation. Where possible, the treatment of pregnancies complicated by PROM remote from term should be directed towards conserving the pregnancy and reducing perinatal morbidity due to prematurity while monitoring closely for evidence of infection, placental abruption, labor, or fetal compromise due to umbilical cord compression. Current evidence suggests aggressive adjunctive antibiotic therapy to reduce gestational age-dependent and infectious infant

2003 Obstetrics and Gynecology

3150. Prolonged latency after preterm premature rupture of membranes: an evaluation of histologic condition and intracranial ultrasonic abnormality in the neonate born at <28 weeks of gestation. (Abstract)

Prolonged latency after preterm premature rupture of membranes: an evaluation of histologic condition and intracranial ultrasonic abnormality in the neonate born at <28 weeks of gestation. The purpose of this study was to evaluate whether infants who were delivered at <28 weeks of gestation after prolonged latency in pregnancies that were complicated by preterm premature rupture of membranes are at increased risk of histologic chorioamnionitis and intracranial ultrasound abnormalities.A (...) for intraventricular hemorrhage, ventriculomegaly, and echolucencies failed to demonstrate significant differences with increasing latency.Ascending transcervical infection after preterm premature rupture of membranes is documented by the increasing odds ratios of placental inflammation. The odds of ultrasonically detectable brain abnormalities, however, did not increase with increasing latency.

2003 American Journal of Obstetrics and Gynecology

3151. Neutrophil granule products: can they identify subclinical chorioamnionitis in patients with preterm premature rupture of membranes? (Abstract)

Neutrophil granule products: can they identify subclinical chorioamnionitis in patients with preterm premature rupture of membranes? Our purpose was to determine whether maternal plasma levels of neutrophil granule products are elevated in patients with chorioamnionitis after preterm premature rupture of membranes (PROM).Fifty-two patients between 24 and 34 weeks' gestation with preterm PROM were included. Plasma samples for defensins and lactoferrin were collected throughout latency. Fifty-two (...) , the sensitivity is 76% and specificity is 94% in predicting histologic chorioamnionitis.Maternal plasma levels of defensins are markers of histologic chorioamnionitis in patients after preterm PROM.

2003 American Journal of Obstetrics and Gynecology

3152. Prediction of preterm premature rupture of membranes by transvaginal ultrasound features and risk factors in a high-risk population. (Abstract)

Prediction of preterm premature rupture of membranes by transvaginal ultrasound features and risk factors in a high-risk population. To determine the transvaginal ultrasound features and risk factors that predict preterm delivery (PTD) preceded by either preterm premature rupture of membranes (PPROM) or preterm labor (PTL) in a high-risk population.Singleton gestations at high-risk for preterm delivery were screened prospectively with transvaginal ultrasound between 14 and 24 weeks. Univariate (...) and multivariate regression analyses were performed for historical obstetric risk factors and transvaginal ultrasound features (cervical length (CL) and cervical funneling (CF)) for the prediction of PTD preceded by PPROM or PTL at < 32 and < 35 weeks' gestation, respectively. Indicated preterm deliveries were excluded.Of 321 patients screened, 71 (22%) delivered at < 35 weeks, 40 (56%) after PPROM and 31 (44%) after PTL. Preterm delivery at < 32 weeks was seen in 47 patients (15%), with 20 (43%) occurring

2002 Ultrasound in Obstetrics and Gynecology

3153. Risk factors for the development of preterm premature rupture of the membranes after arrest of preterm labor. (Abstract)

Risk factors for the development of preterm premature rupture of the membranes after arrest of preterm labor. Our purpose was to determine risk factors predictive of preterm premature rupture of the membranes in women treated for preterm labor with intact membranes.Women with intact membranes participating in a National Institute of Child Health and Human Development multicenter randomized trial of adjunctive antibiotic therapy for preterm labor (24 to 34 weeks) were studied (n = 275). After (...) randomization, 22 women continued to have contractions and were delivered of their infants. The remaining 253 women whose contractions had ceased composed our study population. Preterm premature rupture of the membranes was diagnosed if ruptured membranes occurred > or = 1 hour before the onset of recurrent preterm labor. As part of the study protocol, most women underwent amniocentesis on admission.Preterm premature rupture of the membranes developed in 44% women (17.4%). Women who had preterm premature

1995 American Journal of Obstetrics and Gynecology Controlled trial quality: uncertain

3154. Shigellosis complicating preterm premature rupture of membranes resulting in congenital infection and preterm delivery. (Abstract)

Shigellosis complicating preterm premature rupture of membranes resulting in congenital infection and preterm delivery. The association of chorioamnionitis with preterm birth is well established. Intra-amniotic infection complicates 13-60% of preterm premature rupture of membranes (PROM) with enteric gram-negative pathogens accounting for 20-40% of recoverable organisms. However, the source of enteric pathogens leading to premature birth has been poorly characterized.A 36-year-old multiparous (...) woman presented at 2567 weeks with preterm PROM. She reported a 5-day history of bloody, mucous diarrhea. A fourth cesarean delivery was performed secondary to the onset of labor. Fetal blood, placental membrane, and vaginal pool cultures revealed the presence of Shigella sonnei. With appropriate antibiotic therapy, the patient was discharged home on postoperative day 5. Neonatal stool cultures revealed evidence of in utero fetal transmission.It is prudent to treat pregnant patients with clinical

2002 Obstetrics and Gynecology

3155. Fetal membrane histology in preterm premature rupture of membranes: comparison to controls, and between antibiotic and placebo treatment. The National Institute of Child Health and Human Development Maternal Fetal Medicine Units Network, Bethesda, MD, USA (Abstract)

Fetal membrane histology in preterm premature rupture of membranes: comparison to controls, and between antibiotic and placebo treatment. The National Institute of Child Health and Human Development Maternal Fetal Medicine Units Network, Bethesda, MD, USA The objectives of this study were to test the hypotheses that antibiotic therapy will alter the histologic appearance of fetal membranes in preterm premature rupture of membranes (pPROM), and that the membrane histology will demonstrate (...) distinct differences between term and preterm rupture of membranes. We also wished to test interobserver variability of pathologists. Placental membranes were sampled from 268 women participating in a randomized placebo-controlled trial of antibiotic therapy for pPROM at 24-32 weeks of gestation (cases) and from 4 control groups who were not in the randomized trial: (1) preterm labor without pPROM (n = 21), (2) term labor (n = 65), (3) term PROM (n = 21), and (4) term cesarean section (n = 27

1999 Pediatric and developmental pathology : the official journal of the Society for Pediatric Pathology and the Paediatric Pathology Society Controlled trial quality: uncertain

3156. [Observation and follow-up of premature rupture of the membranes. A pilot study of women at term with immature cervix and premature rupture of the membranes, without contractions]. (Abstract)

[Observation and follow-up of premature rupture of the membranes. A pilot study of women at term with immature cervix and premature rupture of the membranes, without contractions]. In a material of 88 patients with premature rupture of the membranes and unripe cervix, a comparative investigation was undertaken to compare the effects of prostaglandin E2 (PGE2) vaginal tablets and intravenous oxytocin on induction of labour. The patients were subdivided at random into two groups: 42 patients (...) vaginal tablets is considered to be more acceptable by the patients and easier for the staff to use. The tablets were just as safe and reliable in use as intravenous oxytocin for induction of labour in cases of premature rupture of the membranes and Bishop scores less than 6, but the duration of induction was significantly longer.

1990 Ugeskrift for laeger Controlled trial quality: uncertain

3157. International multicenter term PROM study: evaluation of predictors of neonatal infection in infants born to patients with premature rupture of membranes at term. Premature Rupture of the Membranes. (Abstract)

International multicenter term PROM study: evaluation of predictors of neonatal infection in infants born to patients with premature rupture of membranes at term. Premature Rupture of the Membranes. Our objective was to determine significant predictors for the development of neonatal infection in infants born to patients with premature rupture of membranes at term.Multivariate analysis was used to determine the significant predictors of neonatal infection in infants born to women with premature (...) rupture of the membranes who were enrolled in the Term PROM Study. In a randomized, controlled trial, the Term PROM Study recently compared induction of labor with expectant management for premature rupture of membranes at term.The following variables were identified as independent predictors of neonatal infection: clinical chorioamnionitis (odds ratio 5.89, P < .0001), positive maternal group B streptococcal status (vs negative or unknown, odds ratio 3.08, P < .0001), 7 to 8 vaginal digital

1998 American journal of obstetrics and gynecology Controlled trial quality: uncertain

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