The aggressive management of ruptured membranes

Russell, Keith P.; Anderson, Gail

doi:10.1016/0002-9378(62)90089-3

Cited by 69 publications

(23 citation statements)

References 6 publications

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“…The prevalence of this condition in term gestations ranges from 5% to 12% [2], while in preterm gestations, it is diagnosed in 20% of patients with preterm premature rupture of the membranes (PROM) [3–5] and in about 10% of patients with preterm labor and intact membranes [6–11]. Clinical chorioamnionitis is a well-known risk factor for adverse maternal and perinatal outcomes [12–14]. Affected mothers have an increased rate of endometritis [2, 15], post-operative wound infections [2, 16], sepsis [17, 18], disseminated intravascular coagulation [19], septic pelvic thrombophlebitis [20, 21], postpartum hemorrhage [22], pelvic abscess [2], and other complications [2, 4, 23–26].…”

Section: Introductionmentioning

confidence: 99%

Twenty-four percent of patients with clinical chorioamnionitis in preterm gestations have no evidence of either culture-proven intraamniotic infection or intraamniotic inflammation

Kim

Hong

et al. 2017

American Journal of Obstetrics and Gynecology

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Background Recent studies on clinical chorioamnionitis at term suggest that some patients with this diagnosis have neither intra-amniotic infection nor intra-amniotic inflammation. A false-positive diagnosis of clinical chorioamnionitis in preterm gestation may lead to unwarranted preterm delivery. Objective To determine the frequency of intra-amniotic inflammation and microbiologically proven amniotic fluid infection in patients with preterm clinical chorioamnionitis. Study design Amniocentesis was performed in singleton pregnant women with preterm clinical chorioamnionitis (<36 weeks of gestation). Amniotic fluid was cultured for aerobic and anaerobic bacteria and genital mycoplasmas and assayed for matrix metalloproteinase-8 concentration. Microbial invasion of the amniotic cavity was defined as a positive amniotic fluid culture; intra-amniotic inflammation was defined as an elevated amniotic fluid matrix metalloproteinase-8 concentration of >23 ng/mL. Non-parametric and survival techniques were used for analysis. Results Among patients with preterm clinical chorioamnionitis, 24% (12/50) had microbiologic evidence of neither intra-amniotic infection nor intra-amniotic inflammation. Microbial invasion of the amniotic cavity was present in 34% (18/53) and intra-amniotic inflammation in 76% (38/50) of patients. The most common microorganisms isolated from the amniotic cavity were the Ureaplasma species. Finally, patients without microbial invasion of the amniotic cavity or intra-amniotic inflammation had significantly lower rates of adverse outcomes (including lower gestational age at delivery, a shorter amniocentesis-to-delivery interval, acute histologic chorioamnionitis, acute funisitis, and significant neonatal morbidity) than those with microbial invasion of the amniotic cavity and/or intra-amniotic inflammation. Conclusion Among patients with preterm clinical chorioamnionitis, 24% had no evidence of either intra-amniotic infection or intra-amniotic inflammation, and 66% had negative amniotic fluid cultures, using standard microbiologic techniques. These observations call for a re-examination of the criteria used to diagnose preterm clinical chorioamnionitis.

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Section: Introductionmentioning

confidence: 99%

Twenty-four percent of patients with clinical chorioamnionitis in preterm gestations have no evidence of either culture-proven intraamniotic infection or intraamniotic inflammation

Kim

Hong

et al. 2017

American Journal of Obstetrics and Gynecology

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“…Management depends on traditional age, Russel et al 20 have shown that after 36 weeks of gestation 80% established labour within 24 hours whereas before 36 weeks only 50-70% go in labour within 48 hours. They advocate an aggressive approach because of sepsis occurring after PROM.…”

Section: Management Of Prommentioning

confidence: 99%

Maternal and Foetal Outcome in Premature Rupture of Membranes

Patil¹,

Patil²

2014

IOSRJDMS

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“…5,10,18,19,31,37 In one series, 5 neonatal deaths in infants given antibiotics were one third those in nontreated patients. Reduction of fetal mortality and maternal morbidity were more marked in treated cases when the interval between rupture of the membranes and delivery exceeded 48 hours.…”

Section: Discussionmentioning

confidence: 98%

Placental transmission of colistimethate

Macaulay

Charles

1967

Clin Pharma and Therapeutics

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Interest in the transmission of drugs from mother to fetus is now oriented toward rate of transmission rather than mere presence. Interest in the activity of transferred antibiotics in the fetus is directed toward therapeutic and toxic effects. One therapeutic effect of importance is the prevention of intrauterine infection in the case of premature rupture of the membranes. 5 Numerous toxic effects of antibiotics on the developing fetus have resulted from transplacental transfer. s , 9,16 Most of the antibiotics previously studied have had molecular weights of 440 or less. The present study deals with the maternal and fetal distribution of sodium colistimethate (Colistin, Coly-Mycin), a polypeptide antibiotic with a molecular weight Received for publication Jan. 23, 1967. 578of the order of 1,200. Interest in its transfer stems from use in the treatment of urinary tract infections in the female, 2, 10, 29 nephrotoxicity,12, 13, 17, 21, 24 and neurotoxicity.33, 34, 36 Through its antimicrobial activity, this drug makes possible the study of the transfer of a polypeptide from mother to fetus without the use of radioactive materials. Materials and methodsTwo preparations of the antibiotic," 150 mg. (base activity) sodium colistimethate (WI929-41) buffered with 10 mg. citric acid and 50 mg. sodium citrate, and 150 mg. (base activity) lyophilized sodium colistimethate (WI929-46 ), were used.

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The aggressive management of ruptured membranes

Cited by 69 publications

References 6 publications

Twenty-four percent of patients with clinical chorioamnionitis in preterm gestations have no evidence of either culture-proven intraamniotic infection or intraamniotic inflammation

Twenty-four percent of patients with clinical chorioamnionitis in preterm gestations have no evidence of either culture-proven intraamniotic infection or intraamniotic inflammation

Maternal and Foetal Outcome in Premature Rupture of Membranes

Placental transmission of colistimethate

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