Study of vaginal flora in 1000 pregnancies and its association with preterm birth and preterm premature rupture of membranes

2000 ◽  
Vol 70 ◽  
pp. B159-B160
Author(s):  
A. Nishikawa ◽  
M. Takeuchi ◽  
I. Yamanaka ◽  
T. Baba ◽  
N. Akutagawa ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Vaginal Flora ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture

scholarly journals Prevention and Therapy of Preterm Birth. Guideline of the DGGG, OEGGG and SGGG (S2k Level, AWMF Registry Number 015/025, February 2019) – Part 2 with Recommendations on the Tertiary Prevention of Preterm Birth and the Management of Preterm Premature Rupture of Membranes

2019 ◽  
Vol 79 (08) ◽  
pp. 813-833 ◽  
Author(s):  
Richard Berger ◽  
Harald Abele ◽  
Franz Bahlmann ◽  
Ivonne Bedei ◽  
Klaus Doubek ◽  
...  
Keyword(s):  
Preterm Birth ◽  
German Society ◽  
Consensus Conference ◽  
Tertiary Prevention ◽  
Short Version ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Gynecology And Obstetrics ◽  
Self Help Groups

Abstract Aims This is an official guideline of the German Society for Gynecology and Obstetrics (DGGG), the Austrian Society for Gynecology and Obstetrics (ÖGGG) and the Swiss Society for Gynecology and Obstetrics (SGGG). The aim of this guideline is to improve the prediction, prevention and management of preterm birth based on evidence obtained from recently published scientific literature, the experience of the members of the guideline commission and the views of self-help groups. Methods The members of the participating medical societies and organizations developed Recommendations and Statements based on the international literature. The Recommendations and Statements were adopted following a formal consensus process (structured consensus conference with neutral moderation, voting done in writing using the Delphi method to achieve consensus). Recommendations Part 2 of this short version of the guideline presents Statements and Recommendations on the tertiary prevention of preterm birth and the management of preterm premature rupture of membranes.

The Association between Shirodkar Cerclage and Preterm Premature Rupture of Membranes in Singleton Pregnancies

2020 ◽  
Author(s):  
Alberto Muniz Rodriguez ◽  
Andrew Pastor ◽  
Nathan S. Fox
Keyword(s):  
Risk Factors ◽  
Preterm Birth ◽  
Control Group ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Increased Risk ◽  
Uterine Anomalies ◽  
Underlying Risk ◽  
Singleton Pregnancies

Objective The aim of this study was to estimate if preterm premature rupture of membranes in women with cerclage is due to the cerclage itself or rather the underlying risk factors for preterm birth in this population. Study Design This was a retrospective cohort study of singleton pregnancies who underwent Shirodkar cerclage by a single maternal–fetal medicine practice between 2005 and 2019. The control group was an equal number of randomly selected women with a singleton gestation who had a prior preterm birth and were treated with 17-OH-progesterone but no cerclage. Patients with major uterine anomalies or fetal anomalies were excluded. The primary outcome was preterm premature rupture of membranes prior to 34 weeks. Chi-square and logistic regression were used. Results A total of 350 women with cerclage (154 [44%] history-indicated, 137 [39%] ultrasound-indicated, and 59 [17%] exam-indicated) and 350 controls were included. Preterm premature rupture of membranes prior to 34 weeks did not differ between the groups (8.9% in cerclage vs. 6.0% in controls, p = 0.149, adjusted odds ratio 0.62, 95% confidence interval: 0.24–1.64) nor between the different cerclage indications (9.1% of history-indicated, 7.3% of ultrasound-indicated, and 11.9% of exam-indicated, p = 0.582). This study had 80% power with an α error of 0.05 to detect an increase in preterm premature rupture of membranes prior to 34 weeks from 6.0% in the control group to 12.0% in the cerclage group. Conclusion Cerclage does not increase the risk of preterm premature rupture of membranes prior to 34 weeks compared with other women at increased risk of preterm birth. The observed association between cerclage and preterm premature rupture of membranes is likely due to underlying risk factors and not the cerclage itself. The risk of preterm premature rupture of membranes prior to 34 weeks in women with cerclage is 10% or less and does not appear to differ based on cerclage indication. Key Points

scholarly journals A mouse model of spontaneous preterm birth based on the genetic ablation of biglycan and decorin

Reproduction ◽  
2011 ◽  
Vol 142 (1) ◽  
pp. 183-194 ◽  
Author(s):  
Megan L Calmus ◽  
Elyse E Macksoud ◽  
Richard Tucker ◽  
Renato V Iozzo ◽  
Beatrice E Lechner
Keyword(s):  
Preterm Birth ◽  
Fetal Membranes ◽  
Dependent Manner ◽  
Null Mutant ◽  
Wild Type ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Ehlers Danlos Syndrome ◽  
Genetic Ablation ◽  
Preterm Premature Rupture

Preterm premature rupture of membranes is responsible for one-third of preterm births. Ehlers–Danlos syndrome (EDS) is associated with preterm premature rupture of membranes in humans. In particular, an EDS variant is caused by a genetic mutation resulting in abnormal secretion of biglycan and decorin, two small leucine-rich proteoglycans highly expressed in reproductive tissues. Because biglycan/decorin null mutant (Bgn−/−Dcn−/−) mice demonstrate phenotypic changes similar to EDS, we used this model to test whether either biglycan or decorin or both play a role in the attainment of successful term gestation. Wild-type biglycan null mutant, decorin null mutant, and biglycan/decorin null mutant pregnancies were assessed for the length of gestation, pup and placenta weight, and litter size. Quantitative real-time PCR was performed to measure biglycan and decorin gene expression, and immunohistochemistry was performed to assess protein expression in placenta and fetal membranes at embryonic days E12, E15, and E18.Bgn−/−Dcn−/−dams displayed preterm birth, whereas the possession of at least two biglycan or decorin wild-type alleles was protective of preterm birth. The number ofBgn−/−Dcn−/−pups was decreased at postnatal day P1 but not at E18. Biglycan and decorin were upregulated in the placenta in the absence of each other and were developmentally regulated in fetal membranes, suggesting that these two proteoglycans demonstrate genetic complementation and contribute to gestational success in a dose-dependent manner. Thus, the biglycan/decorin null mutant mouse is a model of genetically induced preterm birth and perinatal loss. This model presents novel targets for preventive or therapeutic manipulation of preterm birth.

scholarly journals A study of perinatal outcome in preterm premature rupture of membranes

2018 ◽  
Vol 7 (12) ◽  
pp. 5061
Author(s):  
Poovathi M. ◽  
Yogalaksmi Yogalaksmi
Keyword(s):  
Preterm Birth ◽  
Perinatal Outcome ◽  
Health Centre ◽  
Late Preterm ◽  
Morbidity And Mortality ◽  
Fetal Membrane ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Preterm Group

Background: Preterm premature rupture of membranes is defined as rupture of fetal membrane before onset of labour at less than 37 completed weeks of gestation and after 28 weeks of gestation. Incidence ranges from 3-10% of all deliveries. Preterm premature rupture of membrane is one of the important causes of preterm birth can result inhigh perinatal morbidity and mortality. Preterm premature rupture of membranes complicates 3% of pregnancies and leads to one third of preterm birth. Preterm delivery affects one in 10 birth in USA and even greater birth in developing continues and causes 40-75% neonatal death. There are numerous risk factors for preterm premature rupture of membrane such as maternal, socioeconomic class, infection at early gestational age and associated co-morbid condition. Both mother and fetus are at greater risk of infection after preterm premature rupture of membrane.The fetal and neonatal morbidity and mortality risks are significantly affected by severity of oligohydrominos, duration of latency and gestation at preterm premature rupture of membrane. The objective is to study perinatal outcome in preterm premature rupture of membrane.Methods: This is a prospective study conducted in Mahathma Gandhi Memorial Government Hospital attached to K. A. P. V. Government Medical College, Trichy, Tamil Nadu, India. This is a tertiary health centre. This study has been conducted from January 2018 to June 2018.Results: Incidence of PPROM ranges from 3.0-10.0% of all deliveries. PPROM complicates approximately 3% of pregnancies and leads to one third of preterm birth.Conclusions: In present study most of newborn had better 5min Apgar especially late preterm group. In present study RDS was common in early preterm group and hyper bilirubinaemia common in late preterm group. In current study most of patients delivered vaginally compared to 36% of LSCS.

Trends in Spontaneous and Medically Indicated Preterm Birth in Twins versus Singletons: A California Cohort 2007 to 2011

2021 ◽  
Author(s):  
Amen Ness ◽  
Jonathan A. Mayo ◽  
Yasser Y. El-Sayed ◽  
Maurice L. Druzin ◽  
David K. Stevenson ◽  
...  
Keyword(s):  
Risk Factors ◽  
Preterm Birth ◽  
Population Based ◽  
Birth Certificates ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Live Births ◽  
Preterm Premature Rupture ◽  
Key Points ◽  
Hospital Discharge Records

Objective The study aimed to describe preterm birth (PTB) rates, subtypes, and risk factors in twins compared with singletons to better understand reasons for the decline in PTB rate between 2007 and 2011. Study Design This was a retrospective population-based analysis using the California linked birth certificates and maternal-infant hospital discharge records from 2007 to 2011. The main outcomes were overall, spontaneous (following spontaneous labor or preterm premature rupture of membranes), and medically indicated PTB at various gestational age categories: <37, <32, and 34 to 36 weeks in twins and singletons. Results Among the 2,290,973 singletons and 28,937 twin live births pairs included, overall PTB <37 weeks decreased by 8.46% (6.77–6.20%) in singletons and 7.17% (55.31–51.35%) in twins during the study period. In singletons, this was primarily due to a 24.91% decrease in medically indicated PTB with almost no change in spontaneous PTB, whereas in twins indicated PTB declined 7.02% and spontaneous PTB by 7.39%. Conclusion Recent declines in PTB in singletons appear to be largely due to declines in indicated PTB, whereas both spontaneous and indicated PTB declined in twins. Key Points

Complement activation fragments in cervicovaginal fluid are associated with intra-amniotic infection/inflammation and spontaneous preterm birth in women with preterm premature rupture of membranes

2021 ◽  
Author(s):  
Subeen Hong ◽  
Se Jin Lee ◽  
Yu Mi Kim ◽  
Young Eun Lee ◽  
Yehyon Park ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Complement Activation ◽  
Multivariate Analyses ◽  
Premature Rupture Of Membranes ◽  
Spontaneous Preterm Birth ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Increased Risk ◽  
Baseline Covariates ◽  
Cervicovaginal Fluid

Objective: We sought to determine whether the levels of complement and other inflammatory and angiogenic mediators in cervicovaginal fluid (CVF) are independently associated with intra-amniotic infection and/or inflammation (IAI) and imminent spontaneous preterm birth (SPTB, ≤48 hours of sampling) in women with preterm premature rupture of membranes (PPROM). Study design: This was a retrospective study consisting of 85 singleton pregnant women with PPROM at 20+0 to 33+6 weeks. Amniotic fluid (AF) obtained via amniocentesis was cultured and assayed for interleukin-6. CVF samples collected at the time of amniocentesis were assayed for complement C3a, C4a, and C5a, HSP70, M-CSF, M-CSF-R, S100 A8, S100 A9, thrombospondin-2, VEGF, and VEGFR-1 by ELISA. Results: Multivariate logistic regression analyses revealed that elevated CVF concentrations of complement C3a, 4a and 5a were significantly associated with an increased risk of IAI and imminent SPTB, whereas those of M-CSF were associated with IAI, but not imminent SPTB (P=0.063), after adjustment for baseline covariates (e.g., gestational age at sampling). However, univariate and multivariate analyses showed that the CVF concentrations of angiogenic (thrombospondin-2, VEGF, and VEGFR-1) and inflammatory (HSP70, M-CSF-R, S100 A8, and S100 A9) proteins were not associated with either IAI or imminent SPTB. Conclusions: In women with PPROM, elevated CVF concentrations of complement C3a, C4a, and C5a are independently related to an increased risk of IAI and imminent SPTB. These findings suggest that complement activation in CVF is significantly involved in mechanisms underlying preterm birth and in the host response to IAI in the context of PPROM.

Management of born too soon preterm birth complicated by preterm premature rupture of membranes

2016 ◽  
pp. 58-64
Author(s):  
O.B. Malanchuk ◽  
◽  
V.P. Lakatosh ◽  
O.U. Kostenko ◽  
M.I. Antonuk ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Statistical Analysis ◽  
Pregnant Women ◽  
Neonatal Mortality ◽  
Perinatal Complications ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Mortality And Morbidity ◽  
Pregnancy And Childbirth ◽  
Preterm Premature Rupture

In Ukraine, each year born about 1,000 children ELBW, representing 0.3% of all newborns. The survival of infants with ELBW in our country has a slow upward trend and does not exceed 50%. Infants with ELBW have the highest risk of death and are the group most at risk for the development of chronic diseases of the respiratory and nervous systems and sensory apparatus and associated disability. Considering the growth of the number of children at private ELBW on the background PPROM, high perinatal morbidity and infant mortality, reduced health and reproductive capacity of women becoming urgency tactics of pregnancy and labor with premature rupture of membranes. The objective: perynatalniyh reduce complications in terms of 22-28 weeks of pregnancy complicated by premature rupture of membranes based on developing the tactics of pregnancy and childbirth. Patients and methods. To reduce perinatal complications analyzed the effect of different methods of pregnancy and childbirth on the state of newborns in gestational age 22-28 weeks against the backdrop of premature discharge of amniotic fluid. The control group consisted of 56 women who had less than a day anhydrous term. In the study group applied expectant tactics of anhydrous long term. Depending on the length of the term of anhydrous main group was divided into 2 subgroups. Sub-IA amounted to 86 pregnant women with anhydrous period of 5 days, and IP subgroup totaled 64 pregnant women with anhydrous period of 25 days. Statistical analysis of the results was performed using Microsoft Excel. Probability difference calculated by Student’s t-criterion. Results. Аnalyzing the structure and frequency of obstetric and perinatal complications in women in the period 22-28 weeks of pregnancy with different duration waterless terms, different terms of delivery proved the effectiveness of the tactics of delivery, which is used in perinatal centers m. Kyiv. This correlates with clinical data - statistical analysis of indicators of neonatal mortality and morbidity. Conclusion. Оf the research found that the rates of neonatal mortality and morbidity affecting: duration of anhydrous interval, gestational period, methods of delivery. Long expectant tactics leads to a real reduction of RDS, but an increase in the incidence of chorioamnionitis and neonatal infection. Therefore, wait-recommended tactics for 5 days, followed by delivery of women. At 22-27 weeks of pregnancy delivery path has no impact on rates of neonatal morbidity. The advantage in the delivery of women in the period 27-28 weeks, especially in the immature cervix and pelvic peredlezhenni fetal provided cesarean section. Key words: born too soon preterm birth, preterm premature rupture of membranes, pregnancy, method of delivery, birth with extremely low body weight.

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