Document Detail


Aggressive intervention of previable preterm premature rupture of membranes.
MedLine Citation:
PMID:  22536879     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Objective. To assess the neonatal and maternal outcomes complicated by previable preterm premature rupture of membranes (PPROM). Design. Retrospective study. Setting. Tertiary referral hospital. Sample. Forty-five women having aggressive intervention with antibiotics, amnioinfusion, cerclage and tocolysis. Methods. The hospital database between July 2001 and December 2009 was reviewed for women with singleton fetuses and PPROM before 23(+0) weeks' gestation. We analyzed maternal and neonatal characteristics. Main Outcome Measures. Neonatal survival without major morbidity. Results. Thirty-eight infants were delivered alive and seven were stillborn. Ten infants died in the neonatal intensive care unit and one on the labor ward. Twenty-seven live-born infants survived to discharge from hospital. Survival rate of pregnancies with aggressive management was 60% (27/45); that of live-born infants was 71.1% (27/38). The median gestational age at PPROM and at delivery were significantly lower in the non-surviving group than the surviving group. Thirty-seven women (82.2%) had an amniotic neutrophil elastase level over 0.15 μg/ml. Only four women (8.9%) developed clinical chorioamnionitis. Overall, 90.7% of the women showed histologic evidence of chorioamnionitis. Eighty-three percent of the surviving children had bronchopulmonary dysplasia. Nine infants had serious sequela at corrected age of one and a half years. Maternal complications were uncommon. Conclusions. An aggressive treatment protocol for women with previable PPROM resulted in a high neonatal survival rate. Neonatal survival was associated with higher gestational age at delivery and with more frequent use of antenatal corticosteroids. The prognosis is still bad in PPROM before 22(+0) weeks' gestation.
Authors:
Ken Miyazaki; Madoka Furuhashi; Kana Yoshida; Kaoru Ishikawa
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-4-27
Journal Detail:
Title:  Acta obstetricia et gynecologica Scandinavica     Volume:  -     ISSN:  1600-0412     ISO Abbreviation:  -     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-4-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370343     Medline TA:  Acta Obstet Gynecol Scand     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2012 Nordic Federation of Societies of Obstetrics and Gynecology.
Affiliation:
1Department of Obstetrics and Gynecology, Japanese Red Cross Nagoya Daiichi Hospital, Nagoya, Japan.
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