Document Detail

Expectant management of preterm premature rupture of membranes and nonvertex presentation: what are the risks?
MedLine Citation:
PMID:  17547897     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Preterm premature rupture of membranes (PPROM) continues to be a major cause of preterm births. The objective of this study was to compare the morbidity of patients with PPROM nonvertex presentations with patients with PPROM with vertex presentations. STUDY DESIGN: A retrospective analysis of data from 74 patients with PPROM with nonvertex presentations (study group) and 74 patients with PPROM with vertex presentations (control group) comprised the 2 study groups. All patients that met the study admission criteria were treated in a similar manner at 1 of 3 level-III hospitals. The gestational ages at delivery of all patients were between 23-34 weeks, and the gestational ages between case and control patients were matched for gestational age. RESULTS: A statistically significant (P = .03) higher incidence of a prolapsed umbilical cord was found in the study group (n = 8; 10.8%) relative to the control group (n = 1; 1.4%). More infants in the study group had low 5-minute Apgar scores (<5) and/or low cord pH (<7.20; n = 25 [33.8%]) than in the control group (n = 12 [16.2%]; P = .02). Five infants with breech presentations underwent a precipitous unplanned vaginal delivery. Significant morbidity was not detected in these 5 infants. CONCLUSION: After transfer to an antenatal ward, patients with PPROM with nonvertex presentations appear to have a significantly higher risk for prolapsed umbilical cords, lower Apgar scores, and/or lower umbilical cord blood pH values, when compared with their vertex counterparts. Additionally, there appears to be substantial risk of an unintended, vaginal breech delivery.
David F Lewis; Alfred G Robichaux; Ronald K Jaekle; Amber Salas; Bernard J Canzoneri; Kelly Horton; Lauren Jaekle; Charles Stedman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  196     ISSN:  1097-6868     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-06-05     Completed Date:  2007-10-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  566.e1-5; discussion 566.e5-6     Citation Subset:  AIM; IM    
Department of Obstetrics and Gynecology, Louisiana State University Health Sciences Center, Shreveport, LA 71130-3932, USA.
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MeSH Terms
Apgar Score
Breech Presentation*
Case-Control Studies
Delivery, Obstetric
Fetal Membranes, Premature Rupture / epidemiology*
Gestational Age
Hydrogen-Ion Concentration
Pregnancy Outcome
Retrospective Studies
Umbilical Cord / chemistry

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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