scholarly journals Features of labor induction with patients with the premature rupture of membranes associated with the lack of biological readiness for deliveri in case of full-term pregnancy

2016 ◽  
Vol 65 (1) ◽  
pp. 4-8 ◽  
Author(s):  
Vyacheslav M Bolotskih ◽  
Marina H Afanasieva ◽  
Tatiana U Kuzminykh

The comparative analysis of outcomes of term delivery has been performed in this paper depending on the approach to labor induction affected by the premature rupture of membranes (PROM). A significant improvement in obstetric indicators has been revealed in case of prescription of Mifepristone 6 hours before the labor induction. The deterioration of obstetric indicators with patients with PROM when inducing labor in connection with the lack of biological readiness for delivery has been shown.

2017 ◽  
Vol 4 (4) ◽  
pp. 187-193
Author(s):  
V. V Astafev ◽  
S. V Nazarova ◽  
A. D Li ◽  
N. M Podzolkova

Premature rupture of membranes (PRM) during full-term pregnancy is a common obstetric complication. Childbirths on the background of PRM are accompanied by an increase in the frequency of the operative deliveries, as well as various obstetric complications. However, for all the diversity of tactics, techniques, clinical recommendations devoted to actions of a doctor in the management of PRM patients, the question of their choice depends on many factors. For more than 20 years of studying the PRM problem, a technique for preparing the cervix, providing 100% result has not been developed. With all the variety of choice of methods, none of them is devoid of shortcomings (contraindications to the use, cost-effectiveness, compliance of the patient, etc.). In this regard, the optimal choice of the tactics of labor in PRM cases is the insurance of the preservation of the health of the future generation.


2020 ◽  
Vol 20 (5-6) ◽  
pp. 15-24
Author(s):  
Maria A. Kaganova ◽  
Natalya V. Spiridonova

Introduction. Premature rupture of membranes during full-term pregnancy represents an increased risk of septic complications for both the mother and the fetus due to the prolongation of the latency period, the period from the discharge of amniotic fluid till the onset of labor. Purpose of the study: to assess the factors affecting the duration of the latent period (from the moment of discharge of amniotic fluid to the development of labor) during full-term pregnancy. Materials and methods. A prospective analysis of the labor of 136 patients with premature rupture of membranes and full-term pregnancy (37-42 weeks) of low and moderate risk groups, without contraindications for vaginal birth was carried out. Patients with Bishops cervical score less than or equal to 7 points made up the main group (70 pregnant women). Patients with mature cervix were included in the comparison group (66 cases). The analysis of the duration of the latent period was carried out with the use of correlation and regression analysis. Results. The time from the moment of discharge of amniotic fluid to the onset of regular labor in the group with a cervix 7 Bishop points was 7.82 4.53 hours, while in the group with a cervix 8 Bishop points it was 4.4 3.23 hours (T = 5.02; p 0.001). The most significant effect on the duration of the latency period was the assessment of the cervix according to Bishop scale (r = 0.48; p 0.001), the gestational age was in the second place (r = 0.23; p = 0.08). In patients who didnt take mifepristone, the main factors influencing the duration of the latency interval were fetal weight (r = 0.31; p = 0.004) and gestational age (r = 0.29; p = 0.008); the increase in these parameters led to the decrease in the latency interval. Women who received 200 mg mifepristone in labour had a significant positive correlation with maternal age (r = 0.36; p = 0.04), negative with maternal weight (r = 0.42; p = 0.01) and cervical Bishop score (r = 0.48; p = 0.004). Women in labor with the longest latency interval, who received mifepristone in a daily dosage of 400 mg, have an inverse correlation for the gestational age (r = 0.39; p = 0.09), connection with the degree of cervical maturity, age, constitutional features, gestational age was not revealed. Conclusion. The main predictors of the duration of the latency period of premature rupture of membranes at full-term pregnancy were the degree of cervical maturity according to Bishop scale, gestational age and fetal weight at birth.


2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Moti Gulersen ◽  
Cristina Zottola ◽  
Xueying Li ◽  
David Krantz ◽  
Mariella DiSturco ◽  
...  

Abstract Objectives To assess the risk of chorioamnionitis in nulliparous, term, singleton, vertex (NTSV) pregnancies with premature rupture of membranes (PROM) and an unfavorable cervix undergoing labor induction with either prostaglandin E2 (PGE2) or oxytocin only. Methods Retrospective cohort of NTSV pregnancies presenting with PROM who underwent labor induction with either PGE2 (n=94) or oxytocin (n=181) between October 2015 and March 2019. The primary outcome of chorioamnionitis was compared between the two groups. Statistical analysis included Chi-squared and Wilcoxon rank-sum tests, as well as logistic regression. For time to delivery, a Cox proportional hazard regression was used to determine the hazard ratio (HR) and adjusted HR (aHR). Results Baseline characteristics were similar between the two groups. Cervical ripening with PGE2 was associated with an increased rate of chorioamnionitis (18.1 vs. 6.1%; aOR 4.14, p=0.001), increased neonatal intensive care unit admissions (20.2 vs. 9.9%; aOR 2.4, p=0.02), longer time interval from PROM to delivery (24.4 vs. 17.9 h; aHR 0.56, p=<0.0001), and lower incidence of meconium (7.4 vs. 14.4%; aOR 0.26, p=0.01), compared to the oxytocin group. Conclusions Based on our data, the use of oxytocin appears both superior and safer compared to PGE2 in NTSV pregnancies with PROM undergoing labor induction.


Author(s):  
Ketut Negara ◽  
Ketut Suwiyoga ◽  
Tjokorda Pemayun ◽  
Anak Agung Sudewi ◽  
Nyoman Astawa ◽  
...  

Objective To determine the role of caspase-3, apoptosis-inducing factor (AIF), and B-cell lymphoma-2 (Bcl-2) expressions in term premature rupture of membrane (PROM). Methods An analytic observational study with case-control design was conducted, involving 52 subjects (37–42 weeks of gestation) who were divided into 2 groups: 26 cases of term delivery with PROM, and 26 controls of term delivery without PROM. The expressions of caspase-3, AIF, and Bcl-2 in the amniotic membrane were determined by immunohistochemistry. Data were analyzed using the chi-squared test. The risk of PROM was expressed by odds ratio (OR). Results There were no significant differences in age, parity and body mass index between the two groups (p > 0.05). High caspase-3 and AIF expressions increased the risk of PROM 17.64 times (OR = 17.64; 95% CI = 4.44–70.07; p = 0.001) and 9.45 times (OR = 9.45; 95% CI= 2.62–34.07; p = 0.001), respectively, while low Bcl-2 expression increased 10.39 times (OR = 10.39; 95% CI = 2.73–39.56; p = 0.001)the risk of PROM . Conclusion High caspase-3 and AIF expressions and low Bcl-2 expression were risk factors for term PROM. Caspase-dependent and independent pathways of apoptosis were involved in the mechanism of PROM in term pregnancy.


2021 ◽  
Vol 15 (6) ◽  
pp. 1423-1425
Author(s):  
J. Zain ◽  
M. Asim ◽  
K. Firdos ◽  
T. Laique

Background: Premature rupture of membranes (PROM) is a leading cause of neonatal morbidity and mortality. Aim: To compare the outcomes of prophylactic versus selective antibiotics in term newborns born after PROM > 18 hours in terms of neonatal sepsis and resistance of neonatal. Study design: Randomized controlled trial. Methodology: This study enrolled (n=120) asymptomatic term (37+ weeks) babies of either gender with PROM > 18 hours after ethical review committee’s (ERC) approval. This study held at DHQ Hospital, Rawalpindi-Pakistan in 2019. Data was collected through a structured proforma with informed consent. Data was analyzed by SPSS, v-20. The study outcomes were neonatal sepsis and resistant neonatal flora. Chi-square test was applied with p≤0.05 taken as significant. Results: The neonatal sepsis was diagnosed in 8 (13.3%) and 9(15%) babies in the prophylactic treatment group and the selective treatment group, respectively having statistically insignificant difference (p>0.05). Likewise, resistant neonatal flora between both groups showed statistically insignificant difference (p>0.05). Conclusion: We concluded that there was insignificant difference in terms of rates of neonatal sepsis and resistant neonatal flora between two treatment groups. However, there is a need to conduct large sample size, multicentre studies to validate these results before making recommendations for routine treatment of full term babies with PROM >18 hours in our clinical settings. Keywords: Neonates, Premature Rupture Of Membranes, Full Term, Neonatal Sepsis and Resistant Neonatal Flora.


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