OBJECTIVE: Preterm premature rupture of the membranes (PROM) has been attributed to ascending infection and a choriodecidual inflammatory response (ie, on the maternal side). However, on the fetal side those most at risk of morbidity have a systemic proinflammatory cytokine response. We have recently defined a similar proinflammatory response in ...

OBJECTIVE: The aim of this study was to estimate the effectiveness of cervical fetal fibronectin assayed by the rapid fetal fibronectin assay in predicting preterm delivery in patients with signs or symptoms of preterm labor. METHODS: Patients with preterm labor between 24 and 34 weeks of gestation were included. At ...

OBJECTIVE: To determine whether the adjunctive administration of aminophylline and magnesium sulfate to mothers at risk for preterm birth can reduce the rate of intraventricular hemorrhage in neonates born at less than 30 weeks of gestation. STUDY DESIGN: A prospective study was conducted to determine whether the rate of intraventricular ...

OBJECTIVE: To assess outcomes for pregnancies progressing beyond 20 weeks' gestation in women of very advanced maternal age. DESIGN: Retrospective cohort study. SETTING: Two tertiary level obstetric hospitals. POPULATION: Women aged 45 years or more at the time of delivery over a 10-year period from 1 January 1992 to 31 ...

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 ...

BACKGROUND: Despite extensive evaluation, our understanding of risk factors for premature delivery is incomplete. OBJECTIVE: To examine whether a woman's health status and risk factors before pregnancy are associated with a woman's risk of preterm delivery, independent of risk factors that occur during pregnancy. DESIGN, SETTING, AND PARTICIPANTS: Prospective cohort ...

OBJECTIVE: The relationship between a polymorphism at position -670 in the Fas gene (TNFRSF6) and preterm premature rupture of membranes (PPROM) in multifetal pregnancies was examined. METHODS: Buccal swabs from 119 mother-infant sets were analyzed for an adenine (A) to guanine (G) substitution at position -670 in the TNFRSF6 promoter. ...

AIMS: To study the value of interleukin (IL)-8, IL-6 and IL-1beta in vaginal wash as predictors of preterm delivery. METHODS: A prospective analysis of a study group of 200 pregnant women between 24 and 34 weeks of gestation with intact membranes and preterm labor and a control group of 50 ...

OBJECTIVE: To characterize neonatal and maternal morbidity and mortality rates in pregnancies complicated by preterm premature rupture of membranes (PROM) and determine whether there is an optimal delivery gestational age. METHODS: We reviewed maternal and neonatal outcomes of women with PROM 24 weeks or more that resulted in delivery at ...

OBJECTIVES: The aim of this case-control study was to ascertain if women who experienced a preterm (or premature) birth had any differences in periodontal disease severity compared with women who delivered at term. MATERIAL AND METHODS: Subjects were recruited postpartum. Case subjects delivered a baby before 37 weeks of gestation ...

PURPOSE: To expand on prior (often contradictory) research implicating maternal infection as a cause of preterm birth, specifically exploring whether bacterial vaginosis (BV) in pregnancy caused preterm birth in a sample of 103 women in a rural Mississippi obstetric-gynecologic clinic. DATA SOURCES: This descriptive correlational study explored the relationship between ...

The authors retrospectively evaluated maternal and fetal outcomes of 73 consecutive singleton pregnancies complicated by preterm premature rupture of amniotic membranes. When preterm labor occurred and fetuses were at a viable gestational age, pregnant patients were managed aggressively with tocolytic therapy, antenatal corticosteroid injections, and antenatal fetal testing. The mean ...

OBJECTIVE: To perform a systematic review of the literature to determine whether singleton pregnancies resulting from IVF-ET/GIFT are at higher risk for preterm birth (<37 weeks). DESIGN: Literature search and systematic review. SETTING: Medical school. INTERVENTION(S): A MEDLINE search (1965-2000) was performed using the terms "premature labor," "infertility," "pregnancy complications," ...

Preterm premature rupture of the membranes (preterm PROM) is a common and significant cause of preterm birth and perinatal morbidity and mortality. The obstetric caregiver has the opportunity significantly to alter pregnancy and perinatal outcome for women suffering from this complication. Although management is often predetermined by the presence of ...

AIMS: To review the demographic characteristics, antecedents and outcome for early neonatal Escherichia coli sepsis. Secondary aims were to identify antenatal antibiotic use and to review the antimicrobial susceptibility. METHODS: A retrospective chart review was performed for all infants with a positive culture for E. coli from either blood or ...

The role of the obstetrician is to help predict and prevent maternal/fetal infection/inflammation related to neonatal mortality and morbidity. Predictive studies have mainly focused on the high-risk phenotype. Currently, there is a scientific drive to analyse the genetic susceptibility of preterm birth (PTB). Studies of the combination of environmental and ...

OBJECTIVE: To study the outcomes of pregnancies complicated with preterm premature rupture of the membranes (PPROM) between 26-36 week gestation. METHODS: A retrospective study of 36670 pregnancies registered and managed in the Department of Obstetrics and Gynecology, King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia (KSA) from March 1993 ...

AIM: To evaluate the role of Doppler waveforms of uterine vessels and electromyography (EMG) of the uterus in predicting preterm labor. METHODS: One hundred ante-natal women at >or=24 weeks of gestation who fulfilled the selection criteria were included in the study. A single Doppler recording for bilateral uterine vessels was ...

OBJECTIVE: The objective of this study was to define the most critical gestation period for adverse effects of environmental toxics in terms of preterm delivery (<37 weeks) and low birthweight (<2500 g) in humans. STUDY DESIGN: From January 1, 1987 to December 31, 1989, 704 women were included in a ...

This study investigated the subjective experiences of the maternal role transition during the first two weeks of hospitalization for premature rupture of the amniotic membranes (PROM). Thirteen pregnant couples participated in the study by completing interviews. Average gestation of the expectant mothers was 27 weeks and the women were already ...

Histologic expressions of the fetal inflammatory response predict preterm delivery and neonatal disorders. We examined 1146 placentas in the Developmental Epidemiology Network data set for histologic evidence of membrane inflammation (subchorionitis, chorionitis, and chorioamnionitis) and fetal vasculitis (acute umbilical vasculitis or chorionic vasculitis). Our main findings are that (1) in ...

Rupture of the membranes before the fetus has achieved viability within the womb is an event of enormous importance for both mother and physician. The potential outcome ranges from fetal death, a frequent occurrence, to a severely disabled life or a happy (but rare) birth without any mental or physical ...

OBJECTIVES: Recent advances in the physiology of human pregnancy have implicated placental corticotropin-releasing hormone (CRH) as one of the primary endocrine mediators of parturition and possibly also of fetal development. The aim of this study was (1) to prospectively assess the relationship of maternal plasma concentrations of CRH in the ...

OBJECTIVE: Currently, physicians manage preterm premature rupture of membranes (PPROM) by expectant management or termination of the gestation. A therapy aimed at sealing membranes would be optimal to maintain the pregnancy and achieve a normal neonate. Our objective was to compare an endoscopic technique for intrauterine closure of fetal membrane ...

OBJECTIVE:To examine maternal and neonatal outcomes in expectant management of spontaneous preterm premature rupture of membranes (PPROM) before 24 weeks. STUDY DESIGN: Patients presenting with spontaneous PPROM from 14 to 23 completed weeks' gestation between January 1, 1995 and December 31, 1999 were reviewed. A total of 108 pregnancies were ...

OBJECTIVE: The purpose of this study was to use a decision-analytic approach to explore the best strategy for the timing of the delivery of preterm intrauterine growth-restricted fetuses. STUDY DESIGN: We constructed a decision-analysis model that compared 4 antenatal fetal testing strategies The fetal/neonatal states that were compared included live ...

OBJECTIVES: The purpose of this study was to examine the association between previous pregnancy losses and subsequent risk of preterm delivery. STUDY DESIGN: A population-based Swedish study including information on all births and women's hospital admissions for pregnancy loss (n = 601,883) in Sweden between 1987 and 2000 was performed. ...

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 ...

OBJECTIVE: The aim of this study was to determine: a) to what extent application of antibiotics enhances efficiency of tocolysis; b) whether the duration of antibiotic treatment influences its efficacy; c) what criterion is decisive for efficacy of tocolysis assisted by antibiotic therapy. MATERIALS AND METHODS: 223 successive women with ...

OBJECTIVE: The purpose of this study was to determine the relationship between preterm premature rupture of membranes, tumor necrosis factor-alpha, and heat shock protein-70 gene polymorphisms in multifetal gestations. STUDY DESIGN: Buccal swabs from 101 mother-neonate pairs of multifetal pregnancies were tested for single nucleotide polymorphisms at position -308 of ...

According to many studies, generalised periodontitis can be a risk factor for preterm birth (PB). A case-control study was carried out to examine if early localised periodontitis could be a risk factor for adverse pregnancy outcome. MATERIAL AND METHODS: Postpartum women without any systemic disease were included into the study. ...

Preterm premature rupture of membranes (PPROM) occurs in 3% of pregnancies and is responsible for one third of all preterm births. PPROM will affect 120,000 women in the United States each year. It is associated with significant maternal, fetal, and neonatal morbidity and mortality resulting from infection, umbilical cord compression, ...

BACKGROUND: Preterm premature rupture of membranes (PROM) is associated with one-third of preterm births. In about 50% of preterm PROM cases, the fetuses will elicit a fetal inflammatory response syndrome (FIRS). FIRS is associated with the impending onset of preterm labor, periventricular leukomalacia, neonatal sepsis, and long-term handicap, including the ...

Male dominance being higher at preterm than term delivery was described in a population-based study by Vatten and Skjaerven [Early Hum. Dev. 76 (2004) 47]. A so-called "reversion" and "cross-over" in the sex ratio took place in preeclamptic gestations. These phenomena occurred earlier and stronger when associated with perinatal mortality ...

Preterm premature rupture of membranes (PPROM) occurs in 3% of pregnancies and is responsible for one third of all preterm births. In part I of this series, the definition, pathophysiology, and diagnosis of PPROM was reviewed. In this part, treatment is discussed. Adjunctive antibiotic and corticosteroid therapy has the strongest ...

OBJECTIVE: To assess the relationship between second-trimester uterine artery (UtA) Doppler measurements and spontaneous preterm delivery. METHODS: This was a retrospective analysis of UtA Doppler findings at 18-23 weeks' gestation in 234 singleton pregnancies with spontaneous preterm labor and 5472 pregnancies delivered at term. Cases with fetal chromosomal or structural ...

BACKGROUND: Our purpose was to determine whether AFI<5 cm after preterm premature rupture of the membranes (PPROM) is associated with an increased risk of perinatal morbidity. METHODS: We performed a prospective cohort study of 95 singleton pregnancies complicated by preterm premature rupture of the membranes (PPROM) with delivery between 26 ...

OBJECTIVE: To compare pregnancy and economic outcomes in women receiving inpatient vs outpatient tocolysis with continuous subcutaneous terbutaline (SQT). STUDY DESIGN: Identified within a database were women prescribed SQT at 24.0 to 33.9 weeks' gestation following stabilization of an acute episode of preterm labor. Women with cervical dilatation >3 cm, ...

An intensive debate is ongoing in this journal concerning the most appropriate endpoint after assisted reproduction techniques. The endpoint suggested by the first authors was Birth Emphasizing a Successful Singleton at Term (BESST). We have evaluated the most appropriate endpoint from different perspectives: patients, public, health authorities, obstetric and IVF ...

OBJECTIVE: We sought to test the hypothesis that nulliparous women with multiple gestations would be more likely to have shorter gestational durations, a higher frequency of previable deliveries, and fewer pregnancy complications when compared with parous women. METHODS: We reviewed the medical records of women who delivered a multiple gestation ...

The influence of pregnancy spacing on preterm delivery (<37 weeks gestation) was examined in a group of mothers attending three Maternal and Child Health centres in three different districts in the city of Alexandria, Egypt between October 2001 and July 2002. All pregnant mothers attending the centres were interviewed or ...

OBJECTIVE: This study was undertaken to evaluate the pregnancy and perinatal outcomes of pregnant women with severe acute respiratory syndrome (SARS). STUDY DESIGN: All pregnant women (12) who presented with SARS in Hong Kong between February 1 and July 31, 2003, were included. The pregnancy and perinatal outcomes were collected. ...

OBJECTIVE: To determine the accuracy with which the absence of fetal breathing movements on ultrasound examination predicts spontaneous preterm birth in women with threatened preterm labor. METHODS: Data sources included Medline, Embase, Pascal, Biosis, Cochrane Library, Medion, National Research Register, SciSearch, conference papers, and manual searching of bibliographies of known ...

OBJECTIVE: The study was aimed to assess the impact of obstetric risk factors for preterm delivery among women with MacDonald cerclage performed due to cervical incompetence. STUDY DESIGN: A cohort study was conducted including all patients with MacDonald cerclage performed at 12-14 weeks gestation due to cervical incompetence (n = ...

PURPOSE: A major advantage of transperineal sonography (TPUS) is its ability to evaluate the cervix without causing any distortion. This study was performed to compare transvaginal sonography (TVUS) and TPUS at 24 weeks of gestation in predicting preterm delivery in low-risk pregnancy. METHODS: Three hundred fifty-seven pregnant women underwent TVUS ...

OBJECTIVE: To evaluate prospectively cervical length measurements and fetal fibronectin detection as predictors of spontaneous preterm delivery in an unselected population of twin pregnancies. METHODS: Transvaginal ultrasound assessments of cervical length were performed serially at 18, 24, 28 and 32 weeks' gestation. Receiver-operating characteristic curves were generated at each time ...

Objective: To study the clinical pattern of ophthalmia neonatorum with the aim of identifying its risk factors. Method: A case-control study of ophthalmia neonatorum (ON) was carried out in 5 hospitals in Kaduna metropolis in northern Nigeria. Two hundred cases were matched with two hundred controls. The male to female ...

Preterm premature rupture of the membranes (PPROM) is diagnosed when rupture of the amniotic membranes occurs prior to the completion of the 36th week of gestation. PPROM accounts for 25% of all cases of premature rupture of the membranes and is responsible for 30%-40% of all preterm deliveries. In mothers ...

Preterm premature rupture of membranes (PPROM) is responsible for 30% of neonatal morbidity and mortality in premature gestations. We sought to evaluate pregnancy outcomes in PPROM managed uniformly with antibiotics and steroids, and to determine what maternal factors influence latency. This was a retrospective analysis of 134 patients at 24 ...

OBJECTIVE: We sought to assess the gestational age at which elective delivery is considered in an otherwise uncomplicated patient with preterm premature rupture of the membranes (PROM) by members of the Society of Maternal Fetal-Medicine (SMFM). STUDY DESIGN: A 3-page survey was mailed to members of the SMFM for this ...