Nursing Care of the Patient With Preterm Premature Rupture of Membranes

Stringer, Marilyn; Miesnik, Susan R.; Brown, LC; Martz, Allison H; Macones, George A.

doi:10.1097/00005721-200405000-00002

Cited by 11 publications

(10 citation statements)

References 15 publications

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“…Clinical management of pPROM before 34 weeks of gestation is generally expectant, with controversies sorrounding the use of amniocentesis, corticosteroids, and tocolytics. In women without signs of infection, the current standard of care is hospitalization and bed rest until there is evidence of ascending infection or documentation of fetal lung maturity [3, 4]. …”

Section: Introductionmentioning

confidence: 99%

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Maternal Plasma Procalcitonin Concentrations in Pregnancy Complicated by Preterm Premature Rupture of Membranes

Torbé

2007

Mediators of Inflammation

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Objectives. Our objective is to compare maternal plasma procalcitonin concentrations in preterm premature rupture of membranes (pPROM) and premature rupture of membranes (PROM) at term with their levels in uncomplicated pregnancy, and to determine whether these concentrations are useful in the diagnosis of pPROM cases suspected of infection and in the prediction of pPROM-to-delivery interval. Study design. Forty eight patients with pPROM, 30 with PROM at term, 31 healthy women at preterm gestation, and 33 healthy women at term were included. In pPROM group, analysis of procalcitonin concentrations with reference to leucocytosis, serum C-reactive protein, vaginal fluid culture, neonatal infection, histological chorioamnionitis and pPROM-to-delivery interval was carried out. Results. Procalcitonin concentrations in pPROM and PROM at term cases were comparable. However, in both groups procalcitonin values were significantly higher than in healthy controls in approximate gestational age. In pPROM group, procalcitonin concentrations between the patients with and without laboratory indices of infection were comparable, as well as between patients who gave birth to newborns with and without congenital infection, and between patients with and without histological chorioamnionitis. The predictive values of procalcitonin determinations were poor. Conclusion. The value of maternal plasma procalcitonin determinations in the diagnostics of pPROM cases suspected of intraamniotic infection, as well as for the prediction of pPROM-to-delivery interval, newborn's infection or histological chorioamnionitis is unsatisfactory. However, procalcitonin concentrations are elevated, both in patients with preterm and term PROMs in comparison to healthy pregnants, and therefore further evaluations are necessary to establish the role of procalcitonin in the pathophysiology of pregnancy.

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Section: Introductionmentioning

confidence: 99%

“…Primary intraamniotic subclinical infection is one of the main causes of pPROM and the early identification of such cases is necessary for choosing the proper mode of management [3, 5]. However, the number of methods of detecting subclinical infection is modest and limited.…”

Section: Introductionmentioning

confidence: 99%

Maternal Plasma Procalcitonin Concentrations in Pregnancy Complicated by Preterm Premature Rupture of Membranes

Torbé

2007

Mediators of Inflammation

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“…The incidence of premature rupture of membranes (PROM) is reported to be between 6 and 10%, with almost 80% of these cases occurring at term 1 . Preterm premature rupture of membranes (pPROM) is diagnosed when rupture of amniotic membranes occurs prior to the completion of the 36th week of gestation 2 . It is one of the most common complications of pregnancy and accounts for nearly 30% of all preterm labors 3 .…”

Section: Introductionmentioning

confidence: 99%

“…1 Preterm premature rupture of membranes (pPROM) is diagnosed when rupture of amniotic membranes occurs prior to the completion of the 36th week of gestation. 2 It is one of the most common complications of pregnancy and accounts for nearly 30% of all preterm labors. 3 In women with pPROM and without signs of infection, active labor or fetal distress, the current standard of care is expectant management with hospitalization and bed rest until there is evidence of ascending infection or documentation of fetal lung maturity.…”

Section: Introductionmentioning

confidence: 99%

Are vaginal fluid procalcitonin levels useful for the prediction of subclinial infection in patients with preterm premature rupture of membranes?

Torbé

Czajka

2005

J of Obstet and Gynaecol

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“…In one study, investigators found that many women reported consequences to being hospitalized, including stress, a loss of control over their pregnancy and familial obligations, boredom, and feeling burdensome for their families and health care professionals (Richter et al, 2007). In this setting, it is recommended that nurses help mothers to manage their stress by listening to and reassuring the mother that she did nothing wrong to cause the condition, by providing ongoing information about the mother’s and baby’s condition, and by involving parents in decision making (Stringer, Miesnik, Brown, Martz, & Macones, 2004). Other investigators described the critical role of spirituality in the women’s health and healing when faced with a high-risk pregnancy (Price et al, 2007).…”

Section: Introductionmentioning

confidence: 99%

How Nurses Assist Parents Regarding Life Support Decisions for Extremely Premature Infants

Kavanaugh

Moro

Savage

2010

Journal of Obstetric, Gynecologic & Neonatal Nursing

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Objective-To describe nurse behaviors that assisted parents to make life support decisions for an extremely premature infant before and after the infant's birth.Design-Qualitative, longitudinal, collective case study where interviews were done pre-and postnatally and medical chart data were collected.Setting-Interviews were conducted face-to-face in a private room in the hospital, in the mother's home, or over the telephone.Participants-A sample of 40 cases (40 mothers, 14 fathers, 42 physicians, 17 obstetric nurses, 6 neonatal nurses, and 6 neonatal nurse practitioners) was recruited from three hospitals that provided high risk perinatal care. Parents were at least 18 years of age, English speaking, and had participated in a prenatal discussion with a physician regarding treatment decisions for their infant due to threatened preterm delivery. Physicians and nurses were those identified by parents who had spoken to them about life support treatment decisions for the infant.Methods-Using a semi-structured interview guide, a total of 203 interviews were conducted (137 prenatal, 51 postnatal, and 15 end-of-life). For this analysis, all coded data related to the nurse's role were analyzed and summarized.Results-Parents and nurses both described several nurse behaviors: providing emotional support; giving information, and meeting the physical care needs of mothers, infants, and fathers. Physicians' description of the nurse behaviors focused on the way nurses provided emotional support and gave information. Conclusions-Nurses play a critical role in assisting parents surrounding life support decisions.Keywords decision making; role of nurses; parent support; life support decisions Life support decisions for infants surrounding a pregnancy with a threatened preterm delivery between 22 and 25 weeks gestation remain challenging for parents and clinicians (Batton, 2009;Chiswick, 2008). Despite the gains in survival rates of preterm infants from 1965 to 1995, the rates have not improved in the last decade (Meadow & Lantos, 2009 1. Life support decisions for infants surrounding a pregnancy with a threatened preterm delivery between 22 and 25 weeks gestation remain challenging for parents and clinicians. 2.For both parents and nurses, providing emotional support was the most commonly reported way that nurses assisted parents during decision making.3. Parents reported that nurses played a very important role as parents were making critical decisions.NIH Public Access

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Nursing Care of the Patient With Preterm Premature Rupture of Membranes

Cited by 11 publications

References 15 publications

Maternal Plasma Procalcitonin Concentrations in Pregnancy Complicated by Preterm Premature Rupture of Membranes

Maternal Plasma Procalcitonin Concentrations in Pregnancy Complicated by Preterm Premature Rupture of Membranes

Are vaginal fluid procalcitonin levels useful for the prediction of subclinial infection in patients with preterm premature rupture of membranes?

How Nurses Assist Parents Regarding Life Support Decisions for Extremely Premature Infants

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