Premature Rupture of the Membranes - Intervention or Not

Tamsen, L.; Lyrenäs, Sven; Cnattingius, Sven

doi:10.1159/000293318

Cited by 30 publications

(11 citation statements)

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“…PROM refers to rupture of the membranes prior to the onset of labor and prior to the onset of clinically apparent labour contractions [ 2 ]. PROM can occur at any gestational age and is classified as “preterm PROM” if the event occurs before 37 weeks of gestation or “term PROM” if the event occurs after 37 weeks of gestation [ 3 - 5 ]. A number of issues are associated with PROM including infection, anatomic and pregnancy-related factors [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Prelabour Rupture of Membranes: Mode of Delivery and Outcome

Ibishi

Isjanovska

2015

Open Access Maced J Med Sci

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BACKGROUND:Pre-labour Rupture of Membranes (PROM) is an important cause of maternal and fetal morbidity and increased rate of cesarean section delivery.AIM:The aim of this study is to investigate the clinical characteristics, PROM-delivery interval, mode of delivery, and early maternal neonatal outcome among pregnant patients presenting with pre-labour rupture of membranes.MATERIAL AND METHODS:This prospective case control study is implemented at the Obstetric and Gynecology Clinic of the University Clinical Center of Kosovo. The study included 100 pregnant patients presenting with prelabour rupture of membranes of which 63 were primigravida and 37 patients were multigravida.RESULTS:The incidence of cesarean section in this study is 28 % and the most common indications for cesarean delivery were fetal distress, malpresentation, cephalopelvic disproportion, and failed induction. The most common maternal complications in this study are chorioamnionitis, retained placenta and postpartum hemorrhage. Neonatal infectious morbidity was present in 16 % of cases.CONCLUSION:PROM is a significant issue for obstetricians and an important cause of maternal and neonatal morbidity and increased rate of cesarean section delivery.

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Section: Introductionmentioning

confidence: 99%

Prelabour Rupture of Membranes: Mode of Delivery and Outcome

Ibishi

Isjanovska

2015

Open Access Maced J Med Sci

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“…Nine prospectively randomised trials have assessed the effects of early oxytocin stimulation on uterine contractions compared with expectant management for induction of labour in patients with PROM 5–13 . Quasi‐randomisation was used in four of the studies 5–7 , 10 and a quasi‐randomised study is in fact not random.…”

Section: Introductionmentioning

confidence: 99%

“…Quasi‐randomisation was used in four of the studies 5–7 , 10 and a quasi‐randomised study is in fact not random. Tamsen et al 11 did not report their method of randomisation. Rydhström et al 12 included 277 patients and their study showed a slightly increased rate of neonatal infections in the group that was conservatively managed.…”

Section: Introductionmentioning

confidence: 99%

A randomised trial of two expectant managements of prelabour rupture of the membranes at 34 to 42 weeks

Ladfors

Mattsson

Eriksson

et al. 1996

BJOG

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Objective To compare obstetric and perinatal outcome between two different expectant managements in women with prelabour rupture of the membranes (PROM). Design A randomised study. Participants One thousand three hundred and eighty‐five women with rupture of the membranes at 34 to 42 weeks without contractions. Interventions Women without contractions 2 h after admission were randomised to early induction the following morning after PROM (early induction group) or induction two days later (late induction group). Women with contractions starting within 2 h after admission were included in the calculations as a short latency group. Digital examinations of the cervix were avoided until onset of active labour. Labour was induced with oxytocin in both groups if no spontaneous contractions occurred or if chorioamnionitis or fetal distress was detected. Main outcome measures The frequency of spontaneous deliveries, operative deliveries, maternal and neonatal infections. Results In nulliparous women, a higher rate of spontaneous deliveries was found in the late induction group (89%) compared with the early induction group (81%) (P < 0.05). The ventouse extraction rate was 7% and 14% respectively (P < 0.05). A low (2–4%) caesarean section rate was recorded and did not differ between the groups. Endometritis was detected in six women after delivery. Sixty‐one children were treated with antibiotics, and no difference could be detected between the groups. Conclusions A higher rate of spontaneous deliveries was found among nulliparous women with prolonged latency as compared with brief latency prior to induction. A protocol of no digital examination before labour was associated with infrequent maternal and fetal morbidity, regardless of latency.

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“…Consequently, whether the patient should be managed expectantly or otherwise is debatable. 12,13 In order to prevent early-onset neonatal GBS sepsis, it has been policy since 1981 for all public antenatal patients at the Royal Women's Hospital, Melbourne, Australia to be screened antenatally for GBS. 14 We have shown that intrapartum chemoprophylaxis administered to all colonized women not only reduces neonatal GBS sepsis, but also is cost effective.…”

mentioning

confidence: 99%

Is antenatal group B streptococcal carriage a predictor of adverse obstetric outcome?

Garland¹,

Kelly²,

Ugoni³

2000

Infect. Dis. Obstet. Gynecol.

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Objectives While early‐onset neonatal GBS sepsis is positively associated with premature birth and prolonged rupture of membranes, there is debate in the literature as to whether maternal GBS colonization is a predictor of adverse obstetric outcome. This is a critical issue to resolve for appropriate management (expectant vs. interventional management) of the patient presenting with premature rupture of membranes, who has no overt signs of sepsis, but who is colonized with GBS. Methods Since 1981 it has been hospital policy to screen all public patients antenatally for genital carriage of GBS by collection of a low vaginal swab at 28–32 weeks. All patients colonized with GBS antenatally are given penicillin as intrapartum chemoprophylaxis. Review of all GBS‐colonized antenatal patients for a 12‐month period (580 of 4,495 patients) and a randomized (every fourth consecutive antenatal patient) number of noncolonized patients (958) was made. Lower vaginal GBS colonization and other risk factors for preterm delivery were assessed using univariate and multivariate generalized linear modeling. Results In the study group, the maternal GBS colonization rate was 12.9%. When cofounding variables were controlled in a multivariate analysis, the association between antepartum GBS colonization and preterm labor and preterm rupture of membranes was not significant. Conclusion Maternal antenatal carriage of GBS does not predict preterm labor. Therefore it is appropriate that expectant management occur for a GBS‐colonized woman who ruptures her membranes, is not in labor, and has no evidence of sepsis. Infect. Dis. Obstet. Gynecol. 8:138–142, 2000. © 2000 Wiley‐Liss, Inc.

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Premature Rupture of the Membranes - Intervention or Not

Cited by 30 publications

References 3 publications

Prelabour Rupture of Membranes: Mode of Delivery and Outcome

Prelabour Rupture of Membranes: Mode of Delivery and Outcome

A randomised trial of two expectant managements of prelabour rupture of the membranes at 34 to 42 weeks

Is antenatal group B streptococcal carriage a predictor of adverse obstetric outcome?

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