oalib
Search Results: 1 - 10 of 100 matches for " "
All listed articles are free for downloading (OA Articles)
Page 1 /100
Display every page Item
NEONATAL COMPLICATIONS OF PREMATURE RUPTURE OF MEMBRANES
F. Nili AA. Shams Ansari
Acta Medica Iranica , 2003,
Abstract: Premature rupture of membranes (PROM) is one of the most common complications of pregnancy that has a major impact on neonatal outcomes. With respect to racial, nutritional and cultural differences between developed and developing countries, this study was conducted to detect the prevalence of neonatal complications following PROM and the role of the duration of rupture of membranes in producing morbidities and mortalities in these neonates in our hospital. Among 2357 pregnant women, we found 163 (6.91%) cases of premature rupture of the fetal membranes in Tehran Vali-e-Asr Hospital during April 2001 to April 2002. Route of delivery was cesarean section in 65.6% of women. Urinary tract infection occured in 1.8%, maternal leukocytosis and fever in 20.2% and 5.5%, chorioamnionitis in 6.1%, fetal tachycardia in 1.2% and olygohydramnios in 4.9%. Gestational age in 138 (86%) of neonates was less than 37 completed weeks. Thirty five infants (21.47%) had respiratory distress syndrome and 33 (20.245%) had clinical sepsis. Pneumonia in 6 (3.7%) and skeletal deformity in 7 (4.294%) were seen. Rupture of membrane of more than 24 hours duration occurred in 71 (43.6%) of the patients. Comparison of morbidities between two groups of neonates and their mothers according to the duration of PROM (less and more than 24 hours ) showed significant differences in NICU admission, olygohydramnios, maternal fever, leukocytosis and chorioamnionitis rates (p24 hr of PROM with an odds ratio of 2.68 and 2.73, respectively. Positive blood and eye cultures were detected in 16 cases during 72 hours of age. Staphylococcus species, klebsiella, E.coli and streptococcus were the predominant organisms among positive blood cultures. Mortality was seen in 18 (11%) of neonates because of respiratory failure, disseminated intravascular coagulation, septic shock, and a single case of congenital toxoplasmosis. In this study, the prevalence of prematurity, sepsis and prolonged rupture of membrane were higher than previous studies.
Neonatal Sepsis  [cached]
Ali Bülent Cengiz
Cocuk Enfeksiyon Dergisi , 2009,
Abstract: Sepsis is a significant cause of mortality and morbidity in newborn infants. Depending on the timing of symptoms and signs, sepsis during the neonatal period classically is divided into early-onset sepsis and late-onset sepsis. Primary risk factors for early-onset sepsis are prematurity, low birth weight, prolonged rupture of membranes, chorioamnionitis, and maternal colonization with group B streptococcus. In late-onset sepsis, maternal obstetric complications are rare and the main risk factors for sepsis are the procedures carried out in hospital to keep the infant alive. This article reviews the classification, pathogenesis, etiology, epidemiology, clinical findings of neonatal sepsis and current knowledge regarding the diagnosis and treatment of neonatal sepsis.
Prolonged rupture of membranes in term infants: should all babies be screened?  [cached]
Christopher Flannigan,Martina Hogan
Clinical Audit , 2010,
Abstract: Christopher Flannigan,1 Martina Hogan,21Royal Jubilee Maternity Hospital, Regional Neonatal Unit, Belfast, Northern Ireland; 2Craigavon Area Hospital, Neonatal Unit, Portadown, Northern IrelandBackground: Prolonged rupture of fetal membranes (>24 hours) is a major risk factor for early onset sepsis in neonates. In Northern Ireland there is no consistency on the management of this problem and individual clinical guidelines vary widely between neonatal departments. At present in Craigavon Area Hospital all term babies born with prolonged rupture fetal membranes have screening blood analysis performed, regardless of what is found on risk factor assessment.Setting: The neonatal department of Craigavon Area Hospital a district general hospital in Northern Ireland.Objectives: To determine if the current guidelines on the management of prolonged rupture of fetal membranes in term infants are being followed. The audit will also try to determine if the decision on whether to perform screening blood analysis was left up to the individual doctor’s clinical judgment, would they make a safe decision.Design: A prospective audit was carried out over a three-month period between October 2008 and January 2009. Term infants born during this period where fetal membranes had ruptured for more than 24 hours prior to delivery were included in the audit.Results: At present there is 100% compliance with the current hospital guidelines and there is evidence that if the decision of whether to perform screening blood analysis is left up to the individual doctor’s clinical judgment, they will make a sensible decision based on the infants risk factor assessment. None of the infants that the doctor decided they wouldn’t screen came to any harm.Conclusion: Combining the results of the audit and the availability of nationally recognized guidelines it was decided to adopt the National Institute for Health and Clinical Excellence (NICE) guidelines in Craigavon Hospital. To help facilitate this change a neonatal early warning score (NEWS) observation chart has been developed to record the observations recommended by NICE. As there has been a major change in the management of this condition it is planned to re-audit in the near future to ensure that adopting this less invasive strategy does not result in any increase in adverse neonatal outcomes.Keywords: prolonged rupture of fetal membranes, neonatal, sepsis, audit
Prolonged rupture of membranes in term infants: should all babies be screened?
Christopher Flannigan, Martina Hogan
Clinical Audit , 2010, DOI: http://dx.doi.org/10.2147/CA.S8425
Abstract: olonged rupture of membranes in term infants: should all babies be screened? Original Research (16666) Total Article Views Authors: Christopher Flannigan, Martina Hogan Published Date February 2010 Volume 2010:2 Pages 1 - 6 DOI: http://dx.doi.org/10.2147/CA.S8425 Christopher Flannigan,1 Martina Hogan,2 1Royal Jubilee Maternity Hospital, Regional Neonatal Unit, Belfast, Northern Ireland; 2Craigavon Area Hospital, Neonatal Unit, Portadown, Northern Ireland Background: Prolonged rupture of fetal membranes (>24 hours) is a major risk factor for early onset sepsis in neonates. In Northern Ireland there is no consistency on the management of this problem and individual clinical guidelines vary widely between neonatal departments. At present in Craigavon Area Hospital all term babies born with prolonged rupture fetal membranes have screening blood analysis performed, regardless of what is found on risk factor assessment. Setting: The neonatal department of Craigavon Area Hospital a district general hospital in Northern Ireland. Objectives: To determine if the current guidelines on the management of prolonged rupture of fetal membranes in term infants are being followed. The audit will also try to determine if the decision on whether to perform screening blood analysis was left up to the individual doctor’s clinical judgment, would they make a safe decision. Design: A prospective audit was carried out over a three-month period between October 2008 and January 2009. Term infants born during this period where fetal membranes had ruptured for more than 24 hours prior to delivery were included in the audit. Results: At present there is 100% compliance with the current hospital guidelines and there is evidence that if the decision of whether to perform screening blood analysis is left up to the individual doctor’s clinical judgment, they will make a sensible decision based on the infants risk factor assessment. None of the infants that the doctor decided they wouldn’t screen came to any harm. Conclusion: Combining the results of the audit and the availability of nationally recognized guidelines it was decided to adopt the National Institute for Health and Clinical Excellence (NICE) guidelines in Craigavon Hospital. To help facilitate this change a neonatal early warning score (NEWS) observation chart has been developed to record the observations recommended by NICE. As there has been a major change in the management of this condition it is planned to re-audit in the near future to ensure that adopting this less invasive strategy does not result in any increase in adverse neonatal outcomes.
Neonatal morbidity and mortality results in preterm premature rupture of membranes  [PDF]
Altay,Ezcan,Onur,Veli
Turk Pediatri Ar?ivi , 2011,
Abstract: Aim: To investigate the neonatal morbidity and mortality results in preterm premature rupture of membranes.Material and Method: A review of 228 PPROM singleton pregnancies followed-up in our clinic between 1996 and 2005 was performed.Results: The most common neonatal morbidities in PPROM cases are respiratory distress syndrome, sepsis and intraventricular hemorrhage. The route of delivery does not affect NICU requirement, perinatal asphyxia, sepsis and IVH rates in PPROM cases. NICU and PPV requirement, RDS, sepsis and IVH rates increase if APGAR score is <5. Neonatal morbidity and mortality rates increase as latent period lenghtens. CRP on admission, final CRP, birthweight and the 5th minute APGAR score were found to be associated with NICU requirement; only the 5th minute APGAR score was found to be associated with RDS; final leukocyte count and maternal hemotacrit was found to be associated with sepsis and pneumonia, independently.Conclusions: In PPROM cases, CRP on admission, last CRP, birthweight, the 5th minute APGAR score, final leukocyte count and maternal hematocrit must be considered to predict neonatal outcomes.(Turk Arch Ped 2011; 46: 296-301)
HIV Mother-to-Child Transmission, Mode of Delivery, and Duration of Rupture of Membranes: Experience in the Current Era  [PDF]
Siobhan Mark,Kellie E. Murphy,Stanley Read,Ari Bitnun,Mark H. Yudin
Infectious Diseases in Obstetrics and Gynecology , 2012, DOI: 10.1155/2012/267969
Abstract: Objective. To evaluate whether the length of time of rupture of membranes (ROM) in optimally managed HIV-positive women on highly active antiretroviral therapy (HAART) with low viral loads (VL) is predictive of the risk of mother to child transmission (MTCT) of the human immunodeficiency virus (HIV). Study Methods. A retrospective case series of all HIV-positive women who delivered at two academic tertiary centers in Toronto, Canada from January 2000 to November 2010 was completed. Results. Two hundred and ten HIV-positive women with viral loads <1,000 copies/ml delivered during the study period. VL was undetectable (<50 copies/mL) for the majority of the women (167, 80%), and <1,000 copies/mL for all women. Mode of delivery was vaginal in 107 (51%) and cesarean in 103 (49%). The median length of time of ROM was 0.63 hours (range 0 to 77.87 hours) for the entire group and 2.56 hours (range 0 to 53.90 hours) for those who had a vaginal birth. Among women with undetectable VL, 90 (54%) had a vaginal birth and 77 (46%) had a cesarean birth. Among the women in this cohort there were no cases of MTCT of HIV. Conclusions. There was no association between duration of ROM or mode of delivery and MTCT in this cohort of 210 virally suppressed HIV-positive pregnant women. 1. Introduction In economically developed countries, the human immunodeficiency virus (HIV) infection is now considered a chronic disease, with life expectancy approaching that of the general population [1]. Many HIV-positive women choose to pursue pregnancies [2]. Management of the HIV-positive pregnant patient should focus on both decreasing the risk of mother to child transmission (MTCT) and minimizing maternal and neonatal complications. The Society of Obstetricians and Gynaecologists of Canada (SOGC) and American College of Obstetricians and Gynecologists (ACOG) recommend that elective cesarean section (cesarean section before labor or rupture of membranes (ROMs) be performed for delivery when viral load is detectable [3] or greater than 1000 copies/mL [4] as there is a 12-fold increased risk of MTCT [3, 5]. This is based on several studies that showed that the combination of intrapartum zidovudine (ZDV) and elective cesarean section significantly decreased vertical transmission compared to other delivery modes [6–8]. With the addition of highly active antiretroviral therapy (HAART), the risk of vertical transmission has continued to decrease [5]. ROM increases fetal exposure to maternal blood and vaginal fluids, and prolonged duration of ROM has been shown to be a significant risk factor
MANAGEMENT PRELABOUR RUPTURE OF THE MEMBRANES AT TERM
MISBAH KAUSAR JAVAID
The Professional Medical Journal , 2008,
Abstract: Objective: To find out maternal and fetal outcome in induction of labourcompared with expectant management for prelabour rupture of membranes at term. Design: Open randomizedcomparative study. Setting and period: Gynae Unit- II Services Hospital, from 1st April 2007 to 30 September 2007.Patient and methods: 100 patients at > 37 weeks with ruptures membranes with no contraindication to vaginal deliverywere enrolled in the study. 50 patients were in the expectant group while 50 patients were in the induction group.Results: Both groups had the same general characteristics but the Misoprostol group had a significantly shorter latancyperiod (10-16 hour Vs 20-24 hours), shorter period of hospitalization, lesser LSCS rate (24% Vs 34%) lesser need ofaugmentation (40% Vs 62%), choroamnionitis (3% Vs 7.8%), and postpartum fever (1% Vs 1.8%) when compared withexpectant group. Rate of infected wound after LSCS were compared in induction and expectant groups (2.2% Vs2.6%), also there was no difference between them regarding neonatal morbidity and nursery admission. Conclusion:So it was concluded that there was slightly high maternal complications in expectant group but no long-term maternalmorbidity. Both groups have no effect on neonatal morbidity and mortality however the duration between PROM anddelivery effect the neonatal admission in nursery and antibiotic requirements.
INDUCTION OF LABOUR VERSUS EXPECTANT MANAGEMENT FOR PREMATURE RUPTURE OF MEMBRANES AT TERM  [cached]
Vidyadhar B Bangal,Pujil Gulati,Kunnal K Shinde,Sai K Borawake
International Journal of Biomedical Research , 2013, DOI: 10.7439/ijbr.v3i3.328
Abstract: Background :Premature rupture of the membranes at term is spontaneous rupture of the membranes after 37 wks of the gestations and before the onset of the regular painful uterine contractions .It occurs in ten percent of cases These cases are either managed conservatively or by immediate induction of labour. Material and Methods :A prospective, randomized controlled study was carried out for a period of two years from November 2008 to October 2010 at Rural Medical College, Loni. One hundred pregnant women with term PROM were assigned randomly, each in induction and expectant group. Results :.The mean interval from induction to delivery was significantly shorter in the induction group as compared with expectant group . Incidence of maternal morbidity was comparable in both the groups Neonatal morbidity was higher in expectant group . Incidence of hyper stimulation were more with induction group as compared to expectant group. There was no maternal or perinatal mortality in any group. Intrapartum complications and mode of delivery were similar in both groups Conclusion: Immediate induction of labour in cases of PROM at term using oral misoprostol resulted in shorter induction delivery interval but increased rate of operative intervention. Maternal morbidity was comparable with induction and expectant line of management. However, neonatal morbidity was higher in expectant group
INDUCTION OF LABOUR VERSUS EXPECTANT MANAGEMENT FOR PREMATURE RUPTURE OF MEMBRANES AT TERM  [cached]
Vidyadhar B Bangal,Pujil Gulati,Kunnal K Shinde,Sai K Borawake
International Journal of Biomedical Research , 2012, DOI: 10.7439/ijbr.v3i3.328
Abstract: Background :Premature rupture of the membranes at term is spontaneous rupture of the membranes after 37 wks of the gestations and before the onset of the regular painful uterine contractions .It occurs in ten percent of cases These cases are either managed conservatively or by immediate induction of labour. Material and Methods :A prospective, randomized controlled study was carried out for a period of two years from November 2008 to October 2010 at Rural Medical College, Loni. One hundred pregnant women with term PROM were assigned randomly, each in induction and expectant group. Results :.The mean interval from induction to delivery was significantly shorter in the induction group as compared with expectant group . Incidence of maternal morbidity was comparable in both the groups Neonatal morbidity was higher in expectant group . Incidence of hyper stimulation were more with induction group as compared to expectant group. There was no maternal or perinatal mortality in any group. Intrapartum complications and mode of delivery were similar in both groups Conclusion: Immediate induction of labour in cases of PROM at term using oral misoprostol resulted in shorter induction delivery interval but increased rate of operative intervention. Maternal morbidity was comparable with induction and expectant line of management. However, neonatal morbidity was higher in expectant group
Clinical course of preterm prelabor rupture of membranes in the era of prophylactic antibiotics
Vorapong Phupong, Lalita Kulmala
BMC Research Notes , 2012, DOI: 10.1186/1756-0500-5-515
Abstract: A total of 170 cases of singleton pregnant women with gestational age between 28–34?weeks suffering from PROM during January 1998 to December 2009 were included; 119 cases received prophylactic antibiotics and antenatal corticosteroids while 51 cases did not received prophylactic antibiotics and antenatal corticosteroids. Median latency period in the study group was significantly longer than in the control group (89.8 vs. 24.3?hours, P?<?0.001). The percentage of patients who did not deliver within 48?hours and within 7?days in the study group were also significantly higher than in control group (64.7 vs. 31.4%, P?<?0.001 and 29.4 vs. 7.8%, P?=?0.002, respectively). Maternal infectious morbidity was comparable between groups (17.6% vs. 13.7%, P?=?0.52). Neonatal infectious morbidity was significantly lesser in study group than control group (21% vs. 35.3%, p?=?0.04).Latency period of PPROM after using prophylactic antibiotics and antenatal corticosteroids increased while neonatal infectious morbidity was low. But maternal infectious morbidity was not increased. This retrospective study confirms the benefit of prophylactic antibiotics and antenatal corticosteroids in management of PPROM.Prelabor or premature rupture of membranes is defined as rupture of membranes before onset of labor [1]. Preterm prelabor rupture of membrane (PPROM) is prelabor rupture of membranes that occurs before 37?weeks gestation. PPROM usually results in preterm birth and causes 1/3 of preterm birth. PPROM causes complications not only in the neonate but also in the mother [1]. These complications are more common in PPROM of less than 34?weeks gestation [2].In the past, management of women with PPROM was expectant without any medications. Several studies reported that the latency period after PPROM was 1.5-4.6?days [3-5]. Fifty to ninety-three percent cases and 69.3-97.3% cases delivered within 48?hours and 7?days following rupture of membranes, respectively [3-7].After two large randomized c
Page 1 /100
Display every page Item


Home
Copyright © 2008-2017 Open Access Library. All rights reserved.