Document Detail


Preterm prelabour rupture of the membranes before 28 weeks: better than feared outcome of expectant management in Africa.
MedLine Citation:
PMID:  16229934     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To document the prognosis after conservative management of patients with membrane rupture at gestations less than 28 weeks. STUDY DESIGN: Prospective observational study of 78 women with confirmed membrane rupture at less than 28 weeks gestation, managed conservatively. Antibiotics were given from the time of membrane rupture till delivery. Patients were delivered if clinical infection supervened, there was fetal compromise, spontaneous labour ensued or if the pregnancy continued to 34 completed weeks gestation. RESULTS: The mean gestational age at membrane rupture was 23.3+/-3.17 weeks (16.5-27.8) and the median 24 weeks. Mean latency period was 24.1+/-29.1 days (1.5-154) with a median of 12.5 days. Eight women (10%) delivered between 24 and 48 h, 25 (32%) within 7 days and 55 (70%) within 1 month. Of note is that 23 patients (30%) had latency periods of greater than 1 month. The mean gestational age at delivery was 26.7+/-3.92 weeks. Overall of the 78 women there were 81 fetuses delivered, of which 35 (43%) survived. Survival was related to latency period, birth weight and gestational age at delivery. Sixteen women (20%) developed chorioamnionitis. There was no increase in the incidence of clinical infection with increasing latency period. Compression limb abnormalities occurred in 17% of neonates and lung hypoplasia in 18%. CONCLUSION: Conservative management of patients with very preterm prelabour membrane rupture offers a survival rate of at least 40% with no serious complications in a study of 78 women.
Authors:
Chantal J M Stewart; Shaun K Tregoning; G Moller; H Wainwright
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Publication Detail:
Type:  Journal Article     Date:  2005-10-17
Journal Detail:
Title:  European journal of obstetrics, gynecology, and reproductive biology     Volume:  126     ISSN:  0301-2115     ISO Abbreviation:  Eur. J. Obstet. Gynecol. Reprod. Biol.     Publication Date:  2006 Jun 
Date Detail:
Created Date:  2006-05-29     Completed Date:  2006-08-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375672     Medline TA:  Eur J Obstet Gynecol Reprod Biol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  186-92     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynaecology, University of Cape Town Medical School, Anzio Road, Observatory 7925, Cape Town, South Africa. cstewart@global.co.za
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Birth Weight
Chorioamnionitis
Female
Fetal Membranes, Premature Rupture / epidemiology*,  etiology,  pathology,  therapy*
Gestational Age
Humans
Infant, Newborn
Outcome Assessment (Health Care)*
Perinatal Care*
Pregnancy
Pregnancy Outcome
Pregnancy Trimester, Second
Prognosis
Prospective Studies
South Africa / epidemiology

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


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