| Perinatal outcome following conservative management of mid-trimester pre-labour rupture of the membranes. | |
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MedLine Citation:
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PMID: 9145355 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To assess perinatal outcome and the effect of antenatal steroid use following conservative management of 86 consecutive singleton pregnancies complicated by pre-labour rupture of membranes (ROM) in the mid-trimester (13-26 weeks; mean 22.8 weeks). METHODOLOGY: Review of obstetric and neonatal case notes between 1 January 1990 and 31 December 1993. RESULTS: The duration of ruptured membranes (latent period) ranged from 1.25 to 105 days (mean 23.8 days; median 14 days) and was inversely related to gestational age at ROM. There was clinical evidence of chorioamnionitis in 39.5% with placental histological changes consistent with chorioamnionitis in 76.6%. All infants were delivered before 33 weeks gestation (mean 26 weeks). Overall, the mortality rate was 43.0% but 62.5% in infants with ROM before 24 completed weeks gestation. Adverse outcome (defined as death, severe intraventricular haemorrhage (IVH) or periventricular leucomalacia (PVL)) occurred in 46.5% and was significantly related to both gestation at delivery and gestation at ROM. In the group (n = 40) with ROM before 24 weeks gestation, adverse outcome occurred in 65% and was inversely related to gestation at ROM independent of gestation at delivery. Antenatal steroid administration resulted in less adverse outcome independent of gestation at delivery (OR 0.31; 95% CI (0.09-0.98; P = 0.046)). CONCLUSION: From the neonatal perspective conservative management is justified for pregnancies with ROM at or after 24 weeks gestation; in this group the use of antenatal steroids prior to delivery may improve perinatal outcome. A poor outcome is associated with ROM that occurs before 24 weeks gestation. |
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Authors:
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C B Nourse; P A Steer |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of paediatrics and child health Volume: 33 ISSN: 1034-4810 ISO Abbreviation: J Paediatr Child Health Publication Date: 1997 Apr |
Date Detail:
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Created Date: 1997-07-30 Completed Date: 1997-07-30 Revised Date: 2007-09-24 |
Medline Journal Info:
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Nlm Unique ID: 9005421 Medline TA: J Paediatr Child Health Country: AUSTRALIA |
Other Details:
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Languages: eng Pagination: 125-30 Citation Subset: IM |
Affiliation:
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Department of Neonatology, Mater Mothers' Hospital, Annerley, Queensland, Australia. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Age Factors Cerebral Hemorrhage / epidemiology, etiology Chi-Square Distribution Confidence Intervals Female Fetal Membranes, Premature Rupture / complications, mortality, therapy* Gestational Age Humans Infant, Newborn Leukomalacia, Periventricular / epidemiology, etiology Odds Ratio Perinatal Care / methods, standards* Pregnancy Pregnancy Outcome Queensland / epidemiology Regression Analysis Respiratory Tract Diseases / epidemiology, etiology Retrospective Studies Steroids / therapeutic use* Tocolysis / standards* |
| Chemical | |
Reg. No./Substance:
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0/Steroids |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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