Vaginal probiotics as an adjunct to antibiotic prophylaxis in the management of preterm premature rupture of the membranes

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.

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Neonatal lymphocyte subpopulations analysis and maternal preterm premature rupture of membranes: a pilot study

Clinical Chemistry and Laboratory Medicine (CCLM) ◽

10.1515/cclm-2021-0375 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Margherita Amadi ◽

Silvia Visentin ◽

Francesca Tosato ◽

Paola Fogar ◽

Giulia Giacomini ◽

...

Keyword(s):

T Cells ◽

Immune System ◽

T Cell ◽

T Helper Cells ◽

Lymphocyte Subpopulations ◽

T Helper ◽

Premature Rupture Of Membranes ◽

Premature Rupture ◽

Preterm Premature Rupture ◽

Helper Cells

Abstract Objectives Preterm premature rupture of membranes (pPROM) causes preterm delivery, and increases maternal T-cell response against the fetus. Fetal inflammatory response prompts maturation of the newborn’s immunocompetent cells, and could be associated with unfavorable neonatal outcome. The aims were to examine the effects of pPROM (Mercer BM. Preterm premature rupture of the membranes: current approaches to evaluation and management. Obstet Gynecol Clin N Am 2005;32:411) on the newborn’s and mother’s immune system and (Test G, Levy A, Wiznitzer A, Mazor M, Holcberg G, Zlotnik A, et al. Factors affecting the latency period in patients with preterm premature rupture of membranes (pPROM). Arch Gynecol Obstet 2011;283:707–10) to assess the predictive value of immune system changes in neonatal morbidity. Methods Mother-newborn pairs (18 mothers and 23 newborns) who experienced pPROM and controls (11 mothers and 14 newborns), were enrolled. Maternal and neonatal whole blood samples underwent flow cytometry to measure lymphocyte subpopulations. Results pPROM-newborns had fewer naïve CD4 T-cells, and more memory CD4 T-cells than control newborns. The effect was the same for increasing pPROM latency times before delivery. Gestational age and birth weight influenced maturation of the newborns’ lymphocyte subpopulations and white blood cells, notably cytotoxic T-cells, regulatory T-cells, T-helper cells (absolute count), and CD4/CD8 ratio. Among morbidities, fewer naïve CD8 T-cells were found in bronchopulmonary dysplasia (BPD) (p=0.0009), and more T-helper cells in early onset sepsis (p=0.04). Conclusions pPROM prompts maturation of the newborn’s T-cell immune system secondary to antigenic stimulation, which correlates with pPROM latency. Maternal immunity to inflammatory conditions is associated with a decrease in non-major histocompatibility complex (MHC)-restricted cytotoxic cells.

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Sildenafil versus Nifedipine Treatment of PRETERM LABOR: RCT

QJM ◽

10.1093/qjmed/hcaa056.032 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

M A Alkady ◽

M H Mostafa ◽

R K Elkattan

Keyword(s):

Preterm Labor ◽

Normal Pregnancy ◽

The United States ◽

Labor Pain ◽

University Hospital ◽

P Value ◽

Term Pregnancy ◽

Premature Rupture ◽

Preterm Premature Rupture ◽

Future Therapy

Abstract Background a normal pregnancy lasts 37 to 42 weeks, counting from the first day of the last menstrual period. A pregnancy that continues beyond 37 weeks is called a “term” pregnancy. Preterm labor is defined as labor that begins before 37 weeks of pregnancy. Approximately 12 percent of babies in the United States are born preterm; 80 percent of these are due to preterm labor that occurs on its own or after preterm premature rupture of the fetal membranes (or “broken bag of waters”). The remaining 20 percent are planned early deliveries that are done for maternal or fetal problems that prevent the woman from being able to safely continue with her pregnancy. Aim of the Work to assess the efficacy of sildenafil for stopping the labor for 48 hrs compared to nifedipine in women with preterm labor. Patients and Methods this prospective study was carried on pregnant women with preterm labor pain at Ain Shams University Hospital from March 2018 till September 2018. Study includes 88 patients which were distributed into two groups: Group S: received Sildenafil to stop preterm labor.Group N: received Nifedipine to stop preterm labor. Results in the present study we found that mean age in group receiving sildenafil (group S) was 26.55 years and in group receiving nifidpine (group N) was 26.75 years with insignificant differences between two groups as regard age p-value 0.798, also as regard. BMI and parity there was insignificant differences between two groups as regard BMI p-value 0.727, 0.815 respectively, Mean Gestational age at admission was 27.1 weeks in group S and in group N was 28.16 with insignificant differences between two groups p-value 0.705. Conclusion administration of Sildenafil in women with preterm labor pain seems to be a promising future therapy of preterm labor with, limiting the teratogenic influence of the drugs on the fetus.

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