scholarly journals Ketuban pecah dini dan tatalaksananya

2019 ◽  
Vol 19 (3) ◽  
Author(s):  
Mohd. Andalas ◽  
Cut Rika Maharani ◽  
Evans Rizqan Hendrawan ◽  
Muhammad Reva Florean ◽  
Zulfahmi Zulfahmi

Abstrak. Ketuban Pecah Dini (KPD) atau Premature rupture of Membranes (PROM) merupakan pecahnya ketuban yang terjadi sebelum proses persalinan. Ketuban pecah dini terjadi sekitar 1% dari seluruh kehamilan. Ketuban pecah dini menyebabkan terjadinya 1/3 persalinan preterm dan merupakan penyebab 18%-20% dari morbiditas dan mortalitas perinatal. Dalam laporan kasus ini kami melaporkan seorang ibu hamil berusia 35 tahun, gravida 3, hamil aterm dengan ketuban pecah dini, keluhan keluar air dari jalan lahir dan belum inpartu. Laporan kasus ini bertujuan untuk meningkatkan kualitas diagnosa dini serta penatalaksanaan ketuban pecah dini untuk mengurangi risiko bagi ibu dan janin. Abstract.Premature Rupture of Membranes (PROM) is the rupture of amniotic sac prior to the onset of labor beyond 37 week of gestation. Premature Rupture of Membranes occurs in 1% ofall pregnancies. Premature Rupture of Membranes causes 1/3 preterm delivery and a major  18%-20% cause of perinatal morbidity and mortality. In this case report we reported a 35 year old woman with pregnant 3rd child, aterm wiht Premateur rupture of Membrane (PROM) and prior to labor. This report aims to improve the quality of early diagnosis and management of premature rupture of membranes to reduce the risk for the mother and fetus. 

Author(s):  
Sailaja Surayapalem ◽  
Vijayalakshmi Cooly ◽  
Bhuvaneswari Salicheemala

Background: Premature rupture of membranes is defined as rupture of foetal membranes before the onset of labour. Management of cases of PROM still remains as one of the most difficult and controversial problems in obstetrics. PROM can cause maternal complications like chorioamnionitis, increased operative procedures, puerperal sepsis and neonatal morbidity and mortality. The present study is undertaken to study the labour outcome, maternal morbidity and perinatal morbidity and mortality in term PROM.Methods: 200 Cases of spontaneous rupture of membranes with gestational age >37 weeks with confirmed PROM by a speculum examination were selected. A detailed history was taken, and gestational age confirmed, general, systemic and obstetric examinations were done. Parameters of maternal and foetal well being were recorded. All study groups received prophylactic antibiotics. Single pelvic examination done, and maternal vitals recorded fourth hourly. All the data was analyzed and statistical significance was calculated using Chi-square test.Results: PROM was common in age group of 20-24 years (35%) with mean age of 22.6 years and SD of 2.8 years, and common in primigravida. Majority of women were admitted within six hours of PROM (41.5%) and Mean duration of induction to delivery interval was 12.9 hours. The mean duration between PROM to delivery was 20.2 hours which was statistically significant. Cesarean sections were more among primigravidas. Failure to progress was the common indication. Maternal morbidity was significant (17.5%). No maternal mortality in the study. Perinatal mortality was 1.5%. Birth asphyxia was the commonest cause. Perinatal morbidity was seen in 26%. Escherichia coli was common organism found in cervical swab culture.Conclusions: In present study, majority was primigravidas and the most common age group was 20-24 years belonging to low socioeconomic status. Maternal morbidity and neonatal morbidity was associated with increased duration of PROM to delivery and infection of the female genital tract with pathogens. Hence an appropriate and accurate diagnosis of PROM is essential for favorable outcome in pregnancy.


Author(s):  
Shweta Avinash Khade ◽  
Amarjeet Kaur Bava

Background: This is an observational analytical study carried out in department of obstetrics and Gynecology, in a tertiary care center to determine the factors influencing fetal and maternal outcome, prognosis and complications in preterm premature rupture of membrane cases.Methods: The present study is a prospective observational study of perinatal and maternal outcome in 100 cases of preterm premature rupture of membranes in between 2837 weeks gestation with singleton pregnancy, from 1st March 2013 to 28th February 2014. Patients with medical complications like anemia, preexisting hypertension, diabetes, vascular or renal disease, multiple gestations, uterine or fetal anomalies etc. are excluded from the study. Detailed history, physical examinations were carried out and appropriate management instituted as per individual patients need.Results: In this study maternal morbidity was 16%. Perinatal morbidity was 33% and most common causes were hyperbilirubinemia (23%), RDS (21%).  Perinatal mortality was seen in 15% and mainly due to RDS (53%). Twenty-five (25%) neonates were delivered by cesarean. The main indications for cesarean being malpresentation (36%) followed by fetal distress (24%).Conclusions: PPROM is one of the important causes of preterm birth that can result in high perinatal morbidity and mortality along with maternal morbidity. Looking after a premature infant puts immense burden on the family, economy and health care resources of the country. An understanding of gestational age dependent neonatal morbidity and mortality is important in determining the potential benefits of conservative management of preterm PROM at any gestation.


2018 ◽  
Vol 32 (19) ◽  
pp. 3278-3287 ◽  
Author(s):  
Limor Besser ◽  
Liat Sabag-Shaviv ◽  
Maayan Yitshak-Sade ◽  
Salvatore Andrea Mastrolia ◽  
Danielle Landau ◽  
...  

PEDIATRICS ◽  
1964 ◽  
Vol 33 (3) ◽  
pp. 467-467
Author(s):  
KIT G. JOHNSON

As the article by Pryles, et al. entitled "A Controlled Study of the Influence on the Newborn of Prolonged Premature Rupture of the Amniotic Membranes and/or Infection in the Mother," Pediatrics, Vol. 31, pp. 608-622, has not yet received comment in your journal, perhaps it is not too late to ask the authors to fill three hiati which I felt existed in their presentation of this excellent study. As antibiotics apparently were used (according to Table X) in some infants prior to the diagnosis of clinical sepsis, what were the comparative morbidity and mortality results in this group versus the group in which treatment was deferred until the diagnosis of clinical sepsis could be made?


2020 ◽  
Author(s):  
Eishin Nakamura ◽  
Shigetaka Matsunaga ◽  
Yoshihisa Ono ◽  
Yasushi Takai ◽  
Hiroyuki Seki

Abstract Background: Determination of the optimal timing for termination of pregnancy in cases of preterm premature rupture of membranes (pPROM) during the extremely preterm period is still difficult. Bronchopulmonary dysplasia (BPD) is a major disease widely taken into account when determining the prognosis of respiratory disorders in a neonate. Many aspects of this disease remain unclear. With the aim of further improving the prognosis of neonates born to mothers with pPROM, this study examined cases who were diagnosed with pPROM before 28 weeks of gestation. The study analysed risk factors for neonatal BPD. Methods: This study included 73 subjects with singleton pregnancy, diagnosed with pPROM during the gestational period from 22 weeks and 0 days to 27 weeks and 6 days. The following factors were retrospectively examined: the gestational week at which pPROM was diagnosed, the gestational week at which delivery occurred, the period for which the volume of amniotic fluid was maintained, and neonatal BPD as a complication. Receiver operating characteristic (ROC) curve analyses were conducted to analyse the relationship of the onset of BPD with the duration of oligohydramnios and the gestational weeks of delivery. Results: The mean gestational week at which a diagnosis of amniorrhexis was made was 24.5±1.9 weeks (mean±SD), and that at which delivery occurred was 27.0±3.0 weeks. Fifty-seven cases (78.1%) were diagnosed with oligohydramnios, the mean duration of which was 17.4±20.5 days. The mean birth weight of neonates was 1000±455 g, of which 49 (67.1%) were diagnosed with BPD following birth. No neonates died in this study. The ROC curve indicated that the cut-off values for the duration of oligohydramnios and gestational age at delivery were 4 days and 24.1 weeks, respectively. Multivariate analysis indicated that the duration of oligohydramnios for more than 4 days before delivery and preterm delivery at less than 24.1 weeks were risk factors for the onset of BPD. Conclusion: Our findings suggest that duration of oligohydramnios for more than 4 days before delivery and preterm delivery less than 24.1 weeks are risk factors for BPD in cases who are diagnosed with pPROM before 28 weeks of gestation.


2021 ◽  
Vol 83 (1) ◽  
pp. 1554-1552
Author(s):  
Ahmed Tawfiek Shaaban ◽  
Amira Ahmed Fathey ◽  
Alaa Masoud Abdelgied ◽  
Ragab Mohamed Dawood ◽  
Marwa Mohammed Dawoud

Author(s):  
Zachary Colvin ◽  
Anna Palatnik

This article reviews the study “Fetal Fibronectin in Cervical and Vaginal Secretions as a Predictor of Preterm Delivery,” published in The New England Journal of Medicine in 1991 by Lockwood et al. The study examined the use of fetal fibronectin found in cervicovaginal secretions as a marker for preterm delivery in symptomatic women presenting with preterm contractions or with preterm premature rupture of membranes. The chapter reviews the findings of this study as well as the place of fetal fibronectin testing in current obstetrical practice based on subsequent studies.


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