Document Detail

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.
MedLine Citation:
PMID:  10508879     Owner:  NLM     Status:  MEDLINE    
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). The cases and controls were scored for 40 histologic features by pathologists blinded to the identity of each sample (case or control). pPROM histology of samples from patients receiving antibiotics and those receiving placebo was compared using a chi-squared test and with control groups using logistic regression. There were no histological differences between pPROM cases treated with antibiotic and those receiving placebo, nor with respect to duration of membrane rupture greater or less than 48 h. Concordance among pathologists was low for features other than acute inflammation. Logistic regression analysis controlled for race and pathologist, and demonstrated that all of the control groups had significantly fewer common markers of acute inflammation when compared with the pPROM cases. This study suggests that histopathologic evidence of infection is seen more frequently with pPROM than in preterm or term controls. The histologic features used in this study cannot be used to determine the effectiveness of antibiotic therapy.
R W Bendon; O Faye-Petersen; Z Pavlova; F Qureshi; B Mercer; M Miodovnik; A F Das; P J Meis; A H Moawad; J D Iams; D McNellis
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Pediatric and developmental pathology : the official journal of the Society for Pediatric Pathology and the Paediatric Pathology Society     Volume:  2     ISSN:  1093-5266     ISO Abbreviation:  Pediatr. Dev. Pathol.     Publication Date:    1999 Nov-Dec
Date Detail:
Created Date:  1999-11-16     Completed Date:  1999-11-16     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  9809673     Medline TA:  Pediatr Dev Pathol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  552-8     Citation Subset:  IM    
Department of Pathology, Kosair Children's Hospital, Louisville, KY 40232-5070, USA.
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MeSH Terms
Analysis of Variance
Anti-Bacterial Agents / pharmacology*,  therapeutic use
Chorion / drug effects,  pathology
Extraembryonic Membranes / drug effects*,  pathology
Fetal Membranes, Premature Rupture / drug therapy,  pathology*
Gestational Age
Observer Variation
Time Factors
Grant Support
Reg. No./Substance:
0/Anti-Bacterial Agents

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

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