Antimicrobial therapy in preterm premature rupture of membranes: Results of a prospective, double-blind, placebo -controlled trial of erythromycin

1991 ◽  
Vol 165 (3) ◽  
pp. 632-640 ◽  
Author(s):  
James A. McGregor ◽  
Janice I. French ◽  
Kyung Seo
Keyword(s):  
Antimicrobial Therapy ◽  
Controlled Trial ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Preterm Premature Rupture

A Double-Blind, Randomized, Placebo-Controlled Trial of 17 Alpha-hydroxyprogesterone Caproate in the Management of Preterm Premature Rupture of Membranes

2018 ◽  
Vol 35 (08) ◽  
pp. 779-784 ◽  
Author(s):  
Anita Sit ◽  
Katie Sherwin ◽  
Deirdre Lyell ◽  
Yair Blumenfeld ◽  
Yasser El-Sayed ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Controlled Trial ◽  
Fetal Malformation ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Singleton Pregnancy ◽  
Double Blind ◽  
Randomized Controlled ◽  
Preterm Premature Rupture ◽  
Hydroxyprogesterone Caproate

Objective The objective of this study was to evaluate whether weekly administration of 17 α-hydroxyprogesterone caproate (17-OHPC) increases the number of women who achieve 34 weeks of gestation after preterm premature rupture of membranes (PPROM). Study Design We conducted a multicenter double-blind, randomized controlled trial of 17-OHPC versus placebo among women with PPROM. Women with singleton pregnancy, clinically confirmed PPROM, and without evidence of active infection or major fetal malformation between 240/7 and 320/7 weeks of pregnancy were offered enrollment. Women received weekly injections of 17-OHPC versus placebo until 340/7 weeks of gestation or delivery. The remainder of care was per hospital protocol. The primary outcome was achievement of 34 weeks of gestation. Secondary outcomes included length of latency and maternal and fetal outcomes. Results In this study, 21 women were enrolled. Eleven women received placebo and 10 received 17-OHPC. The study was closed prematurely secondary to poor enrollment. None of the women remained pregnant until 34 weeks of gestation. The median latency periods were 8 and 14.5 days for the placebo and 17-OHPC groups, respectively (p = 0.14). There were no differences in maternal or neonatal outcomes. Conclusion We did not identify any benefit from administration of 17-OHPC in pregnancies complicated by PPROM.

Removal versus retention of cerclage in preterm premature rupture of membranes: a randomized controlled trial

2014 ◽  
Vol 211 (4) ◽  
pp. 399.e1-399.e7 ◽  
Author(s):  
Anna Galyean ◽  
Thomas J. Garite ◽  
Kimberly Maurel ◽  
Diana Abril ◽  
Charles D. Adair ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Randomized Controlled ◽  
Preterm Premature Rupture

scholarly journals The Effect of Transabdominal Amnioinfusion on Perinatal Outcomes in Preterm Premature Rupture of Membranes

2014 ◽  
Vol 6 (1) ◽  
pp. 28-32
Author(s):  
Nasira Tasnim ◽  
Ghazala Mahmud ◽  
Saba Fatima
Keyword(s):  
Controlled Trial ◽  
Latency Period ◽  
Perinatal Outcomes ◽  
Expectant Management ◽  
Management Control ◽  
Control Group ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Significant Prolongation

ABSTRACT Objective To evaluate the role of transabdominal amnioinfusion in improving the latency period and perinatal outcomes of pregnancies complicated by preterm premature rupture of membranes (PPROM). Materials and methods A randomized controlled trial was carried out at MCH Centre, Unit I, PIMS, Islamabad, from Jan 2008 to Dec 2008. Sixty women with singleton pregnancies between 28 and 32 completed weeks of gestation, complicated with PPROM was randomly allocated into two groups viz transabdominal amnioinfusion (amnioinfusion group) and expectant management (control group), within 24 hours of admission. Results The demographic characteristics were comparable in both the groups. Amnioinfusion group showed significant improvement in PPROM to delivery interval (18.47 ± 6.699 vs 8.93 ± 4.741 days; p = 0.001), neonatal birth weight (p = 0.019) and Apgar scores at 1 and 5 minutes (p = 0.007 for 1 minute and p = 0.012 for 5 minutes). There was less frequency of respiratory distress syndrome (p = 0.032), neonatal sepsis (p = 0.020) and neonatal jaundice (p = 0.002) in the amnioinfusion group. Fewer neonates were admitted to NICU (p = 0.010) and higher survival rate was found in amnioinfusion group (p = 0.023). Conclusion The treatment with transabdominal amnioinfusion in pregnancies complicated with PPROM resulted in significant prolongation of pregnancy and better neonatal outcomes as compared to women who were managed with traditional expectant management. How to cite this article Fatima S, Tasnim N, Mahmud G. The Effect of Transabdominal Amnioinfusion on Perinatal Outcomes in Preterm Premature Rupture of Membranes. J South Asian Feder Obst Gynae 2014;6(1):28-32.

scholarly journals The Effect of Non-penicillin Antibiotic Regimens on Neonatal Outcomes in Preterm Premature Rupture of Membranes

2019 ◽  
Vol 09 (01) ◽  
pp. e67-e71 ◽  
Author(s):  
Anne Siegel ◽  
Robert Heine ◽  
Sarah Dotters-Katz
Keyword(s):  
Controlled Trial ◽  
Secondary Analysis ◽  
Standard Of Care ◽  
Neonatal Outcomes ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Adverse Neonatal Outcomes ◽  
Alternative Antibiotic ◽  
The Impact

Objective A 7-day course of a penicillin (PCN) and macrolide is standard of care (SAR) in preterm premature rupture of membranes (PPROM). Data regarding alternative antibiotic regimens are limited. We sought to assess the impact of non-PCN regimens on neonatal outcomes. Study Design Secondary analysis of randomized controlled trial of antenatal magnesium sulfate. Singleton, nonanomalous pregnancies complicated by PPROM at > 24 weeks of gestation receiving the SAR were compared with women receiving a non-β-lactam regimen and a macrolide (NPCR). Primary outcome was a neonatal composite. Secondary outcomes included pregnancy latency, endometritis, and chorioamnionitis. Results A total of 949 women met inclusion criteria; 821(56%) received the SAR and 128(8.8%) received NPCR. Adjusted models did not demonstrate worse outcomes (AOR [adjusted odds ratio] = 0.50; 95% CI [confidence interval]: 0.22–1.11). Neonates receiving SAR were less likely to have bronchopulmonary dysplasia (BPD; p = 0.03) but more likely to have severe necrotizing enterocolitis (sNEC; p = 0.04). Risk for chorioamnionitis and median latency did not differ between groups but women receiving the SAR were less likely to get endometritis (AOR = 0.35; 95% CI: 0.14–0.91). Conclusions In this cohort, receiving NPCR in the setting of PPROM did not impact the overall risk of adverse neonatal outcomes or latency, but did increase the risk of endometritis. Alterations in individual neonatal morbidities suggest follow-up studies are needed.

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