| Active versus expectant management for preterm prelabor rupture of membranes at 34-36 weeks of completed gestation: comparison of maternal and neonatal outcomes. | |
| | |
MedLine Citation:
|
PMID: 20225986 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVE: To compare maternal and neonatal outcomes in deliveries managed by a policy of expectant management and active management of women with preterm prelabor rupture of membranes (pPROM), at 34-36 completed weeks of gestation. DESIGN: Retrospective multicenter cohort study. SETTING: Three tertiary care teaching hospitals in France. POPULATION: Women with pPROM were identified from the databases of three perinatal centers. METHODS: Maternal and neonatal complications were compared according to the hospital policy in effect at pPROM--expectant or active management. MAIN OUTCOME MEASURES: Clinical chorioamnionitis, neonatal morbidity including neonatal infection, respiratory problems, and metabolic disorders. RESULTS: During the seven-year study period, 634 women were admitted for pPROM at 34-36 completed weeks of gestation, 241 of whom were included in the study: 126 in the group with a policy of expectant management and 115 in the active management group. The incidence of clinical chorioamnionitis was 4.8% in the former and 0.9% in the latter (p = 0.07). Neonatal oxygen was still needed at 24 hours significantly more often in the active than in the expectant management group (7.0 vs. 1.6%, p = 0.05). However, after adjustment for gestational age at birth, only delivery at 34 weeks of gestation remained associated with the need for neonatal oxygen at 24 hours. The rate of hypoglycemia or hypocalcemia was 5.6% in the expectant management group versus 12.3% in the active management group (p = 0.07). There were no neonatal deaths. CONCLUSION: A policy of active management, especially at 34 weeks of gestation, was associated with greater neonatal morbidity, whereas an expectant management policy tended to be associated with an increased rate of clinical chorioamnionitis. |
| | |
Authors:
|
Gilles Kayem; Aur?lie Bernier-Dupreelle; Fran?ois Goffinet; Dominique Cabrol; Bassam Haddad |
Related Documents
:
|
20678106 - Aortic complications of giant cell arteritis: a diagnostic and management dilemma. 21221306 - Moderating benzodiazepine use in the elderly: curbing physicians' prescribing practices. 11021326 - Neonatal management at limits of viability: hypothesis based on review of literature an... 16427536 - Anesthetic implications of traumatic pulmonary hernia repair. 5031716 - Sexual behaviour and contraceptive practice of unmarried female undergraduates at aberd... 15069986 - A critique to the european regulatory system. |
Publication Detail:
|
Type: Comparative Study; Journal Article; Multicenter Study |
Journal Detail:
|
Title: Acta obstetricia et gynecologica Scandinavica Volume: 89 ISSN: 1600-0412 ISO Abbreviation: Acta Obstet Gynecol Scand Publication Date: 2010 Jun |
Date Detail:
|
Created Date: 2010-05-27 Completed Date: 2010-06-08 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 0370343 Medline TA: Acta Obstet Gynecol Scand Country: England |
Other Details:
|
Languages: eng Pagination: 776-81 Citation Subset: IM |
Affiliation:
|
Department of Obstetrics and Gynecology, CHI de Cr?teil, Universit? Paris XII, 40 avenue de Verdun, Cr?teil, France. gkayem@gmail.com |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Cohort Studies Female Fetal Membranes, Premature Rupture / therapy* Gestational Age Humans Infant, Newborn Pregnancy Pregnancy Outcome* Retrospective Studies |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Advice given by health-care professionals to mothers concerning subsequent pregnancy after stillbirt...
Next Document: Non-cigarette tobacco use among women and adverse pregnancy outcomes.