Document Detail


Outcomes with premature rupture of membranes at 32 or 33 weeks when management is based on evaluation of fetal lung maturity.
MedLine Citation:
PMID:  15621544     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To assess outcomes of patients with premature rupture of membranes (PROM) at 32 or 33 weeks gestation. METHODS: This historical cohort study included all immune competent patients managed at our institution from October 1, 1999 to March 31, 2003 with singleton gestations and PROM at 32 or 33 weeks, and without clinical chorioamnionitis at presentation or antenatal diagnosis of a fetal anomaly. If amniotic fluid studies revealed pulmonary maturity, patients were intentionally delivered. Otherwise, they were expectantly managed until intentional delivery at 34 weeks, or labor, chorioamnionitis, or non -reassuring testing led to delivery sooner. RESULTS: For the groups with mature (n = 29) and immature or unobtainable (n = 60) fluid, respectively, rates of neonatal ICU admission (83% vs. 77%; p = 0.51), respiratory distress (41% vs. 45%; p = 0.75), mechanical ventilation (10% vs. 17%; p = 0.53), and proven neonatal infection (4% vs. 2%; p = 0.60) were similar, as were rates of other neonatal and maternal complications. The mature group had shorter mean maternal hospital stays (3.6 +/- 0.6 vs. 6.4 +/- 2.9 d; p < 0.001) and latency periods (30.2 +/- 19.3 vs. 83.8 +/- 68.7 h; p < 0.001). CONCLUSION: Compared to those managed expectantly due to immature or unavailable fetal lung studies, intentional delivery of patients with PROM at 32 or 33 weeks with mature fetal lung studies did not increase neonatal morbidity in our small cohort.
Authors:
Rodney Edwards; Laura Stickler; Isaiah Johnson; Patrick Duff
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians     Volume:  16     ISSN:  1476-7058     ISO Abbreviation:  J. Matern. Fetal. Neonatal. Med.     Publication Date:  2004 Nov 
Date Detail:
Created Date:  2004-12-28     Completed Date:  2005-08-17     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  101136916     Medline TA:  J Matern Fetal Neonatal Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  281-5     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Florida College of Medicine, PO Box 100294, Gainesville, FL 32610, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Algorithms
Amniotic Fluid / chemistry*
Cohort Studies
Female
Fetal Membranes, Premature Rupture*
Fetal Organ Maturity
Gestational Age*
Humans
Infant, Newborn
Labor, Induced / methods
Lung / embryology*
Male
Pregnancy
Pregnancy Complications
Pregnancy Outcome
Pregnancy Trimester, Third
Prenatal Diagnosis
Retrospective Studies

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