| Abstrakt: |
A prospective randomized study involving patients with premature rupture of the membranes between the twenty-elghth week and thirty-fourth week of pregnancy was conducted. Patients with chorioamnionitis, advanced labor, and fetal distress, as well as those mature lecithin/sphingomyelin ratios and/or Gram stains positive for bacteria were delivered immediately. The remaining randomized. One group received betamethasone. Tocolytic agents were used in this group when necessary. After 48 hours all patients given corticosteroids(CS group) were delivered. The second group was mamaged expectanly (EM group)and were delivered only when spontaneous labor or infection occurred. A total of 160 patients were randomized, 80 in each group. Maternal outcome, including chorioamnionitis and cesarian section rates, was not different; however, the endometritis rate was significantly higher int the CS group (p < 0.05). Neonatal did not differ in mean birth weights, perinatal death rates, neonatal infections, or incidences of respiratory distress. The frequency of prolonged hospital stay (>4 weeks) was higher in the neonates in the CS group (p < 0.01). conclusion is that corticosteroids and active management in with premature rupture of membranes and prematuresgestations do not decrease of incidence of respiratory distress syndrome or perinatal mortality and may aggravate certain infectious complications. (Am. Osstet. Gynecol. 141:508, 1981.) |
