Factors affecting the rates of caesarean sections in cases with premature rupture of membranes (PROM) at term

Kalem, Müberra Namlı; Köşüş, Aydın; Kamalak, Zeynep; Köşüş, Nermin; Kalem, Ziya

doi:10.1080/01443615.2016.1274291

Cited by 6 publications

(5 citation statements)

References 27 publications

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“…It is also likely that exogenous factors such as the hospital environment, medical procedures, previous antibiotics and the timing of blood cultures/diagnostic parameters also influence the reported bacterial cause of EOS. Although ascending infection and prolonged rupture of membranes (PROM) may necessitate delivery via caesarean section, 60 neonates who go on to develop EOS born via caesarean section may not been exposed to the mother’s microbiome during vaginal delivery and may have acquired the pathogen elsewhere. Available data from LMICs suggest a large overlap in the bacterial species causing EOS and LOS, compared to a discrepancy of species causing EOS and LOS found in data from HICs.…”

Section: Bacterial Species Causing Eosmentioning

confidence: 99%

Early-Onset Neonatal Sepsis in Low- and Middle-Income Countries: Current Challenges and Future Opportunities

Sands

Spiller

Thomson

et al. 2022

IDR

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Neonatal sepsis is defined as a systemic infection within the first 28 days of life, with early-onset sepsis (EOS) occurring within the first 72h, although the definition of EOS varies in literature. Whilst the global incidence has dramatically reduced over the last decade, neonatal sepsis remains an important cause of neonatal mortality, highest in low- and middle-income countries (LMICs). Symptoms at the onset of neonatal sepsis can be subtle, and therefore EOS is often difficult to diagnose from clinical presentation and laboratory testing and blood cultures are not always conclusive or accessible, especially in resource limited countries. Although the World Health Organisation (WHO) currently advocates a ß-lactam, and gentamicin for first line treatment, availability and cost influence the empirical antibiotic therapy administered. Antibiotic treatment of neonatal sepsis in LMICs is highly variable, partially caused by factors such as cost of antibiotics (and who pays for them) and access to certain antibiotics. Antimicrobial resistance (AMR) has increased considerably over the past decade and this review discusses current microbiology data available in the context of the diagnosis, and treatment for EOS. Importantly, this review highlights a large variability in data availability, methodology, availability of diagnostics, and aetiology of sepsis pathogens.

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Section: Bacterial Species Causing Eosmentioning

confidence: 99%

Early-Onset Neonatal Sepsis in Low- and Middle-Income Countries: Current Challenges and Future Opportunities

Sands

Spiller

Thomson

et al. 2022

IDR

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“…Duration of established labour was increased for both primiparous and multiparous women and augmentation was used more frequently than in women without PROM. Both of these factors support the idea that PROM is symptomatic of pathological disturbance in the labour process, as proposed by Li et al (2011);and Namli Kalem et al (2017). Use of pain relief was significantly higher, with 94.3% of women using some form of documented pain relief medications or techniques, including 35.8% using epidural and 30.9% using morphine.…”

Section: Intrapartum Caresupporting

confidence: 69%

“…The 96-hour expectant management period used by Hannah et al (1996) remains an outlier, with all other publications using an expectant management period of 12-24 hours. Both Li et al (2011) and Namli Kalem et al (2017) argued that due to an inherent pathology associated with PROM, if labour does not follow spontaneously within 12 hours, birth should be expedited by either immediate induction of labour or caesarean to avoid poor maternal and neonatal outcomes. Support for planned early birth, defined as 'immediate intervention or intervention within 24 hours', also comes from Middleton et al (2017, p. 1), who found labour duration was shorter for women managed actively and duration of hospital admission was shorter.…”

Section: Discussionmentioning

confidence: 99%

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Management of Prelabour Rupture of Membranes at Term, at Northland District Health Board.

Hay¹

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<p>Background Prelabour rupture of membranes at term (PROM) is a subject of interest to women and maternity care providers alike. Management of PROM varies internationally, and regionally within New Zealand, despite the presence of interprofessional consensus statements. Northland District Health Board (NDHB) policy differs from most maternity care facilities by enabling expectant management of labour for women at low risk of transmission of Group β Streptococcus to their baby to extend to 96 hours from time of rupture of membranes. This study aimed to explore whether the NDHB policy was applied in practice and safely served the needs of women and babies in this DHB. Methods A retrospective quantitative clinical notes review was conducted of files in a one-year sample. The clinical notes of 123 women who had duration from ROM to birth at term of 18 hours or more were reviewed. Statistical comparisons using percentages, means and odds-ratios were made to a one-year sample of all other births at term at NDHB facilities, and with birth data from the New Zealand College of Midwives Clinical Outcomes Research Database (COMCORD). Findings Variables including demographic data, antenatal and intrapartum care given, time factors and outcomes themselves were reviewed. Few variables impacted outcomes within the PROM sample, though use of intravenous oxytocin was associated with increased epidural use and increased incidence of instrumental birth. Wāhine Māori had an increased incidence of vaginal births but some variables and outcomes highlighted inequities, including reduced antenatal screening, a higher incidence of maternal smoking, severe postpartum haemorrhage, and admission to Special Care Baby Units. Duration splits at 48 and 96 hours were applied to identify whether time increased risks for women or babies, but duration did not appear to be a factor which increased risk. The phenomenon of PROM itself increased risk for women and babies, increasing rates of labour induction, augmentation, epidural use, operative births, postpartum haemorrhage, admission to Special Care Baby Units and decreased exclusive breastfeeding at discharge. Conclusions The NDHB PROM policy appeared to be applied consistently and did not appear to increase risk for women and babies. Risks were increased for all women with PROM, with some inequitable outcomes for wahine Māori and pēpi. This research provides a comparison which is informative for clinical practice, education, and future research, and supports women’s involvement in decision-making.</p>

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“…This is because PROM can lead to intraamniotic infection, further cause neonatal mortality or morbidity ( 43 ). The mode of delivery for women with PROM should be decided based upon the safety for both, the infants and their mothers ( 44 ).…”

Section: Discussionmentioning

confidence: 99%

The Inconsistency Between Women's Preference and Actual Mode of Delivery in China: Findings From a Prospective Cohort Study

Feng

Zhang

et al. 2022

Front. Public Health

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BackgroundPrevious studies have found that the rates of cesarean preference were much lower than the actual rates of cesarean births in China. We aimed to observe this inconsistency between preferred and actual modes of delivery and the factors associated with the inconsistency.MethodsWe conducted a prospective cohort study at the maternity hospital with the largest number of deliveries in Beijing. We collected data through a questionnaire applied in the outpatient department, and medical records from the hospital's information system. Unconditional logistic regression was used to identify factors influencing the inconsistency between preferred and actual delivery mode.ResultsThe rates of actual cesarean section and of cesarean preference were 41 and 17%, respectively (χ2 = 82.9, P < 0.0001). The overall inconsistency rate was 31%, with 119 women preferred vaginal delivery but experienced cesarean section, accounting for 67% women undergoing cesarean section. Risk factors for this inconsistency between preferred vaginal delivery and actual cesarean section included: maternal obesity, receiving assisted reproduction, having an abnormal amniotic fluid volume, and fetal distress. Pre-labor rupture of membranes was a unique factor associated with such inconsistency between cesarean section preference and vaginal delivery at delivery.ConclusionsThe inconsistent rate between preferred delivery at late pregnancy and actual delivery is high in China. Further research is needed to understand how to lower cesarean rates in China, taking maternal preferences for vaginal deliveries into account.

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Factors affecting the rates of caesarean sections in cases with premature rupture of membranes (PROM) at term

Cited by 6 publications

References 27 publications

Early-Onset Neonatal Sepsis in Low- and Middle-Income Countries: Current Challenges and Future Opportunities

Early-Onset Neonatal Sepsis in Low- and Middle-Income Countries: Current Challenges and Future Opportunities

Management of Prelabour Rupture of Membranes at Term, at Northland District Health Board.

The Inconsistency Between Women's Preference and Actual Mode of Delivery in China: Findings From a Prospective Cohort Study

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