Perinatal survival with expectant management of midtrimester rupture of membranes
Article Abstract:
Premature rupture of membranes (PROM, rupture of the membranes surrounding the fetus before the onset of labor) occurs in preterm (early in gestation) pregnancies in approximately 1 percent of all pregnancies. Preterm PROM is associated with increased morbidity and mortality of both mother and infant and, when extremely premature, can necessitate termination of the pregnancy. Few reports have appeared concerning outcomes of midtrimester PROM (rupture in the middle of gestation). To learn more about this issue, medical records from 70 women with preterm PROM were evaluated. When examined, the fetuses were between 19 and 25 weeks' gestational age. Patients were managed with bed rest, hospitalization, and frequent monitoring, with daily fetal heart rate testing from week 25 onwards. Details of the expectant management approach are provided. Thirty patients developed clinical amnionitis (inflammation of the amniotic sac, which surrounds the fetus) and 12 developed endometritis (inflammation of the uterine lining) after delivery. The interval from the time that membrane rupture was diagnosed to delivery varied from 24 hours to 60 days. Approximately three-quarters of the patients underwent vaginal delivery. Eleven infants were born dead (all before 25 and one-half weeks' gestation), and 15 died as neonates. Slightly more than half developed respiratory distress syndrome (serious impairment of respiration). The total perinatal mortality was 36 percent. Sixty-eight percent of the surviving infants had normal neurological and physical development at long-term follow-up (one year). Infant survival was more closely related to the gestational age at delivery than to the age at rupture of membranes. Overall, survival of infants after preterm PROM is considerably better than past reports indicate. Pregnant women should be offered the option of expectant management, with careful explanation of the possible risks if they elect to retain the pregnancy. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Obstetrics and Gynecology
Subject: Health
ISSN: 0002-9378
Year: 1990
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Cardiopulmonary bypass support for emergency cesarean delivery in a patient with severe pulmonary hypertension
Article Abstract:
Doctors report the first known case of a pregnant women with pulmonary hypertension who was placed on a cardiopulmonary bypass machine during a cesarean delivery. The baby was delivered prematurely at 26 weeks but the mother died 14 months later.
Publication Name: American Journal of Obstetrics and Gynecology
Subject: Health
ISSN: 0002-9378
Year: 2001
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A comparison of echocardiography and pulmonary artery catheterization for evaluation of pulmonary artery pressures in pregnant patients with suspected pulmonary hypertension
Article Abstract:
About one-third of pregnant women may be incorrectly diagnosed with pulmonary hypertension if echocardiography is used to measure pulmonary artery pressure. Pulmonary hypertension is high blood pressure in the pulmonary arteries.
Publication Name: American Journal of Obstetrics and Gynecology
Subject: Health
ISSN: 0002-9378
Year: 2001
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