[Premature rupture of membranes. Prospective study of 218 cases]
| Autor: | J P, Coste, J B, De Meeus, V, Bascou, G, Magnin |
|---|---|
| Jazyk: | francouzština |
| Rok vydání: | 1994 |
| Předmět: |
Adult
Fetal Membranes Premature Rupture Time Factors Cesarean Section Pregnancy Trimester Third Pregnancy Outcome Tocolysis Infections Anti-Bacterial Agents Pregnancy Complications Chorioamnionitis Adrenal Cortex Hormones Pregnancy Risk Factors Prostaglandins Humans Female Labor Induced Prospective Studies |
| Zdroj: | Journal de gynecologie, obstetrique et biologie de la reproduction. 23(2) |
| ISSN: | 0368-2315 |
| Popis: | To verify the importance of a wait-and-see attitude after premature rupture of the membranes before 34 weeks of amenorrhoea when allowed by the initial physical examination and of an intervening attitude after 34 weeks.A prospective study included 218 cases of premature ruptures of the membranes divided into four groups according to the weeks of amenorrhoea: Group 1, before 32 weeks (n = 11); Group 2, between 32 and 34 weeks (n = 26); Group 3, between 34 and 37 weeks (n = 18); Group 4 after 37 weeks (n = 163).Before 34 weeks of amenorrhoea, the frequency of premature rupture of the membranes was 0.72%, of germ-positive infants 8% and of infected infants, 11%. Perinatal mortality was 80% and 17.4% of the infants were delivered by cesarian section. Labour was induced in 100 cases (46%), when there was evidence of infection, after a 24-hour waiting period or at 34 weeks of amenorrhoea. When the aspect of the cervix was unfavourable, cervical maturation was induced by intravenous injection of prostaglandins in 75 cases (34%).When the rupture occurred before 34 weeks of amenorrhoea and without signs of infection, tocolysis should be entertained. From 28 to 34 weeks and when a favourable outcome is expected, maturation by corticoids can be proposed. When chorio-amniotic infection is suspected and is not confirmed by the laboratory, antibiotic prophylaxy does not appear to improve fetal outcome. The beneficial effect of a conservative wait-and-see attitude before 34 weeks and of intervening thereafter can only be demonstrated with a large randomized study. Thus each case must be managed individually, making it difficult to establish a standard recommended attitude. |
| Databáze: | OpenAIRE |
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