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1.
Rev. Assoc. Méd. Rio Gd. do Sul ; 65(2): 01022501, Abr. - Jun. 2021.
Article in Portuguese | LILACS | ID: biblio-1367816

ABSTRACT

RESUMO Introdução: A ruptura prematura de membranas (RUPREME) ocorre em 3-5% das gestações e está relacionada a graves complica- ções maternas e fetais, especialmente se ocorrer abaixo das 24 semanas de idade gestacional (IG). Descrição: Trata-se de relato de caso com ruptura prematura de membranas com 18 semanas de IG e desfecho gestacional favorável. Discussão: Nascimento com 33 semanas de IG, alta hospitalar do após 34 dias na Unidade de Internação Neonatal sem sequelas significativas. PALAVRAS-CHAVE: Oligoidrâmnios, ruptura prematura das membranas fetais, viabilidade fetal.


ABSTRACT Introduction: Premature rupture of membranes (PROM) occurs in 3-5% of pregnancies and is related to serious maternal and fetal complications, especially if it occurs below 24 weeks of gestational age (GA). Description: This is a case report with premature rupture of membranes at 18 weeks of GA and favorable gestational outcome. Discussion: Birth at 33 weeks of GA, discharge from hospital after 34 days in the Neonatal Inpatient Unit without significant sequelae. KEYWORDS: Oligohydramnios, premature rupture of fetal membranes, fetal viability, premature birth


Subject(s)
Humans , Fetal Membranes, Premature Rupture , Oligohydramnios , Fetal Viability
2.
Rev. bras. ginecol. obstet ; 43(6): 436-441, June 2021. tab
Article in English | LILACS | ID: biblio-1341138

ABSTRACT

Abstract Objective The aim of the present study was to evaluate the risk factors for cesarean section (C-section) in low-risk multiparous women with a history of vaginal birth. Methods The present retrospective study included low-risk multiparous women with a history of vaginal birth who gave birth at between 37 and 42 gestational weeks. The subjects were divided into 2 groups according to the mode of delivery, as C-section Group and vaginal delivery Group. Risk factors for C-section such as demographic characteristics, ultrasonographic measurements, smoking, weight gain during pregnancy (WGDP), interval time between prior birth, history of macrosomic birth, and cervical dilatation at the admission to the hospital were obtained fromthe charts of the patients. Obstetric and neonatal outcomes were compared between groups. Results The most common C-section indications were fetal distress and macrosomia (33.9% [n=77 and 20.7% [n=47] respectively). A bivariate correlation analysis demonstrated that mothers aged>30 years old (odds ratio [OR]: 2.09; 95% confidence interval [CI]: 1.30-3.34; p=0.002), parity >1 (OR: 1.81; 95%CI: 1.18-2.71; p=0.006), fetal abdominal circumference (FAC) measurement>360mm (OR: 34.20; 95%CI: 8.04 -145.56; p<0.001)) and<345mm (OR: 3.06; 95%CI: 1.88-5; p<0.001), presence of large for gestational age (LGA) fetus (OR: 5.09; 95%CI: 1.35-19.21; p=0.016), premature rupture of membranes (PROM) (OR: 1.52; 95%CI: 1-2.33; p=0.041), and cervical dilatation<5cm at admission (OR: 2.12; 95%CI: 1.34-3.34; p=0.001) were associated with the group requiring a C-section. Conclusion This is the first study evaluating the risk factors for C-section in low-risk multiparous women with a history of vaginal birth according to the Robson classification 3 and 4. Fetal distress and suspected fetal macrosomia constituted most of the Csection indications.


Subject(s)
Humans , Female , Pregnancy , Adult , Parity , Cesarean Section/classification , Fetal Macrosomia/complications , Fetal Membranes, Premature Rupture , Labor Stage, First , Case-Control Studies , Retrospective Studies , Risk Factors , Maternal Age , Delivery, Obstetric , Fetal Distress/complications , Sagittal Abdominal Diameter
3.
ABCS health sci ; 46: e021309, 09 fev. 2021.
Article in English | LILACS | ID: biblio-1349415

ABSTRACT

INTRODUCTION: Premature rupture of membranes remains a challenge for professionals due to the high rates of maternal and neonatal morbidity and mortality, mainly related to complications resulting from prematurity. OBJECTIVE: To analyze the scientific production about premature rupture of membranes in pregnancies above 28 weeks and below 34 weeks. METHODS: Integrative literature review carried out in the Lilacs, SciELO, Medline and Cochrane Library databases, between 2014 and 2018, in Portuguese, English and Spanish, including original articles, available in full online, with free access, that addressed the study theme, using the keywords "premature rupture of ovular membranes", "premature labor" and "pregnancy complications" combined using the Boolean operators "AND" and "OR". RESULTS: Fourteen studies were included. It was possible to highlight the main recommendations regarding preterm premature rupture of membranes, divided into six categories for discussion, namely: indications for expectant management and delivery induction, prophylactic antibiotic therapy, prenatal corticosteroids, use of tocolytics, recommendations regarding the use of magnesium sulfate and amniocentesis. CONCLUSION: It was identified that expectant management is the ideal approach, with constant monitoring of the pregnant woman and the fetus, in addition to the administration of prophylactic antibiotics and prenatal corticosteroids, in the face of premature rupture of membranes in pregnancies between 28 and 34 weeks in order to provide the best maternal and perinatal results, guiding health professionals to evidence-based practice.


INTRODUÇÃO: A ruptura prematura de membranas continua a ser um desafio para os profissionais devido às altas taxas de morbimortalidade materna e neonatal, relacionada principalmente às complicações decorrentes da prematuridade. OBJETIVO: Analisar a produção científica acerca das evidências frente a ruptura prematura de membranas em gestações acima de 28 semanas e abaixo de 34 semanas. MÉTODOS: Revisão integrativa da literatura realizada nas bases de dados Lilacs, SciELO, Medline e Cochrane Library, entre 2014-2018, em português, inglês e espanhol, incluídos artigos originais, disponíveis completos online, com acesso livre, que abordassem a temática do estudo, utilizando os descritores "ruptura prematura de membranas ovulares", "trabalho de parto prematuro" e "complicações na gravidez" combinados por meio dos operadores booleanos "AND" e "OR". RESULTADOS: Foram incluídos 14 estudos, nos quais foi possível evidenciar as principais recomendações frente a ruptura prematura de membranas fetais pré-termo, divididos em seis categorias para discussão, sendo elas: indicações para o manejo expectante e indução do parto, antibioticoterapia profilática, corticosteroides pré-natais, uso de tocolíticos, recomendações quanto ao uso de sulfato de magnésio e realização de amniocentese. CONCLUSÃO: O estudo possibilitou identificar que o manejo expectante é a conduta ideal, com monitorização constante da gestante e do feto, além da administração de antibióticos profiláticos e corticosteroides pré-natais, frente a ruptura prematura de membranas em gestações entre 28 e 34 semanas a fim de proporcionar os melhores resultados maternos e perinatais, guiando os profissionais da saúde para uma prática baseada em evidências.


Subject(s)
Humans , Female , Pregnancy , Fetal Membranes, Premature Rupture , Obstetric Labor, Premature , Tocolysis , Adrenal Cortex Hormones , Antibiotic Prophylaxis , Watchful Waiting , Amniocentesis , Labor, Induced , Magnesium Sulfate
4.
Article in Chinese | WPRIM | ID: wpr-879896

ABSTRACT

OBJECTIVE@#To study the clinical features of very preterm infants with prelabor rupture of membranes (PROM) and predictive factors for early-onset sepsis (EOS) and death.@*METHODS@#A retrospective analysis was performed for the clinical data of the very preterm infants with PROM (with a gestational age of < 32 weeks) who were admitted to the neonatal intensive care unit from January 2018 to May 2020. According to the time from membrane rupture to delivery, the infants were divided into four groups: < 18 hours (@*RESULTS@#There was no significant difference in the incidence rates of major neonatal complications and mortality rate among the very preterm infants with different times of PROM (@*CONCLUSIONS@#Prolonged PROM does not increase the incidence of neonatal complications and mortality in very preterm infants. Adverse outcomes of very preterm infants with PROM are mainly associated with lower birth weights, lung immaturity, and systemic infection.


Subject(s)
Female , Fetal Membranes, Premature Rupture , Gestational Age , Humans , Infant , Infant, Newborn , Infant, Premature , Infant, Premature, Diseases , Infant, Very Low Birth Weight , Pregnancy , Retrospective Studies
5.
Article in Chinese | WPRIM | ID: wpr-879804

ABSTRACT

OBJECTIVE@#To study the influence of premature rupture of membranes (PROM) on the early prognosis of extremely premature infants, and to provide a basis for the management of extremely premature infants and prenatal consultation.@*METHODS@#A total of 179 extremely premature singleton infants who were born from 2017 to 2019 were enrolled. According to the presence or absence of PROM, they were divided into two groups: PROM group (@*RESULTS@#Compared with the non-PROM group, the PROM group had significantly higher incidence rates of earlyonset sepsis and necrotizing enterocolitis (NEC) (@*CONCLUSIONS@#PROM increases the incidence rates of early-onset sepsis and NEC in extremely premature infants and does not increase the incidence rates of other adverse outcomes. For pregnant women with PROM at the risk of extremely preterm delivery, prevention of miscarriage and chorioamnionitis is recommended to prolong gestational weeks, reduce the incidence rate of infection, and thus improve the outcome of extremely premature infants.


Subject(s)
Chorioamnionitis , Enterocolitis, Necrotizing/etiology , Female , Fetal Membranes, Premature Rupture/epidemiology , Gestational Age , Humans , Infant , Infant, Extremely Premature , Infant, Newborn , Pregnancy , Prognosis
6.
Rev. bras. ginecol. obstet ; 42(11): 717-725, Nov. 2020. tab, graf
Article in English | LILACS | ID: biblio-1144178

ABSTRACT

Abstract Objective: To compare the type of management (active versus expectant) for preterm premature rupture of membranes (PPROM) between 34 and 36 + 6 weeks of gestation and the associated adverse perinatal outcomes in 2 tertiary hospitals in the southeast of Brazil. Methods: In the present retrospective cohort study, data were obtained by reviewing the medical records of patients admitted to two tertiary centers with different protocols for PPROM management. The participants were divided into two groups based on PPROM management: group I (active) and group II (expectant). For statistical analysis, the Student t-test, the chi-squared test, and binary logistic regression were used. Results: Of the 118 participants included, 78 underwent active (group I) and 40 expectant management (group II). Compared with group II, group I had significantly lower mean amniotic fluid index (5.5 versus 11.3 cm, p = 0.002), polymerase chain reaction at admission (1.5 versus 5.2 mg/dl, p = 0.002), time of prophylactic antibiotics (5.4 versus 18.4 hours, p < 0.001), latency time (20.9 versus 33.6 hours, p = 0.001), and gestational age at delivery (36.5 versus 37.2 weeks, p = 0.025). There were no significant associations between the groups and the presence of adverse perinatal outcomes. Gestational age at diagnosis was the only significant predictor of adverse composite outcome (x2 [1] = 3.1, p = 0.0001, R2 Nagelkerke = 0.138). Conclusion: There was no association between active versus expectant management in pregnant women with PPROM between 34 and 36 + 6 weeks of gestation and adverse perinatal outcomes.


Resumo Objetivo: Comparar o tipo de manejo (ativo versus expectante) para ruptura prematura de membranas (PPROM, na sigla em inglês) entre 34 e 36 semanas e 6 dias de gestação e os resultados perinatais adversos relacionados, em 2 hospitais terciários do sudeste brasileiro. Métodos: No presente estudo de coorte retrospectivo, os dados foram obtidos através da revisão dos prontuários de gestantes internadas em dois centros terciários com protocolos diferentes para o seguimento da PPROM. As gestantes foram divididas em dois grupos com base no manejo da PPROM: grupo I (ativo) e grupo II (expectante). Para análise estatística, foram utilizados o teste t de Student, qui-quadrado e regressão logística binária. Resultados: Das 118 gestantes incluídas, 78 foram submetidas a tratamento ativo (grupo I) e 40 a seguimento expectante (grupo II). Comparado ao grupo II, o grupo I apresentou índice de líquido amniótico médio significativamente menor (5,5 versus 11,3 cm, p = 0,002), reação em cadeia da polimerase na admissão (1,5 versus 5,2 mg/dl, p = 0,002), tempo de antibióticos profiláticos (5,4 versus 18,4 horas, p < 0,001), tempo de latência (20,9 versus 33,6 horas, p = 0,001) e idade gestacional no parto (36,5 versus 37,2 semanas, p = 0,025). Não houve associações significativas entre os grupos e a presença de resultados perinatais adversos. A idade gestacional no diagnóstico foi o único preditor significativo de desfecho composto adverso (x2 [1] = 3,1, p = 0,0001, R2 Nagelkerke = 0,138). Conclusão: Não houve associação entre manejo ativo e expectante em gestantes com PPROM entre 34 e 36 semanas e 6 dias de gestação e resultados perinatais adversos.


Subject(s)
Humans , Female , Pregnancy , Adolescent , Adult , Young Adult , Prenatal Care , Fetal Membranes, Premature Rupture/therapy , Watchful Waiting , Brazil , Pregnancy Outcome , Retrospective Studies , Cohort Studies , Gestational Age , Delivery, Obstetric , Tertiary Care Centers
7.
Rev. méd. panacea ; 9(1): 36-42, ene.-abr. 2020.
Article in Spanish | LIPECS, LILACS, LIPECS | ID: biblio-1121543

ABSTRACT

Introducción: La ruptura prematura de las membranas se define como la ruptura de las membranas fetales de 12 a 18 horas o más antes del inicio del parto. Objetivo: El objetivo principal de esta revisión bibliográfica es generar conocimiento sobre los factores maternos de riesgo asociados a la ruptura prematura de membranas. Materiales y métodos: Es un estudio descriptivo de búsqueda bibliografía y se ha realizado en Pubmed, Medline, Scielo, bibliotecas de universidades nacionales e internacionales. Resultados: Los factores de riesgo hallados tenemos a la edad menor de 20 y mayor de 35 años (OR: 2.2), procedencia rural (OR: 5.8), unión estable (OR: 2.600), gestante mal nutrida (OR: 4.200), obesidad con (OR: 3), antecedente de aborto (OR: 2,76), la gestación múltiple (OR: 4,5), primigesta (OR: 3.370), gran multípara (OR: 2,10), periodo intergenésico corto (OR: 4.128), RPM previo (OR: 4.265), uso DIU (OR: 3.151), acto sexual antes del RPM (OR: 3,182), Hb 9,9-7,1 grs/dl (OR: 2), metrorragia del 1er y2do trimestre (OR: 3.88), infección cérvico-vaginal (OR: 13), infección urinaria (OR: 2,56). Conclusión: Los principales factores maternos de riesgo que condicionan a la ruptura prematura de membranas, tenemos: Edad menor de 20 y mayor de 35 años, procedencia rural, unión estable, gestante mal nutrida, gestante con obesidad, antecedente de aborto, gestación múltiple, primigesta, gran multípara, periodo intergenésico corto, RPM previo, uso DIU, acto sexual antes del RPM, Hb 9,9-7,1 grs/dl, metrorragia del 1er y 2do trimestre, infección cérvico-vaginal, infección urinaria. (AU)


Introduction: Premature rupture of the membranes is defined as the rupture of the fetal membranes 12 to 18 hours or more before the onset of labor. Objective: The main objective of this literature review is to generate knowledge about the maternal risk factors associated with premature rupture of membranes. Materials and methods: It is a descriptive study of literature search and has been carried out in Pubmed, Medline, Scielo, libraries of national and international universities. Results: The risk factors found are at the age of less than 20 and older than 35 years (OR: 2.2), rural origin (OR: 5.8), stable union (OR: 2,600), pregnant woman poorly nourished (OR: 4,200), obesity with (OR: 3), history of abortion (OR: 2.76), multiple gestation (OR: 4.5), primitive (OR: 3.370), large multiparous (OR: 2.10), short intergenic period (OR : 4,128), previous RPM (OR: 4,265), IUD use (OR: 3,151), sexual act before RPM (OR: 3,182), Hb 9,9-7,1 grs / dl (OR: 2), metrorrhagia 1st and 2nd trimester (OR: 3.88), cervical-vaginal infection (OR: 13), urinary infection (OR: 2.56). Conclusions: The main maternal risk factors that condition premature rupture of membranes, we have: Age under 20 and over 35 years of age, rural origin, stable union, malnourished pregnant woman, pregnant woman with obesity, history of abortion, multiple pregnancy, primitive, large multiparous, short intergenic period, prior RPM, IUD use, sexual intercourse before RPM, Hb 9.9-7.1 grs / dl, 1st and 2nd trimester metrorrhagia, cervical-vaginal infection, urinary tract infection. (AU)


Subject(s)
Humans , Female , Adolescent , Adult , Young Adult , Fetal Membranes, Premature Rupture , Pregnancy , Risk Factors , Epidemiology, Descriptive
8.
Managua; s.n; s.n; feb. 2020. 74 p. ilus, tab, graf.
Thesis in Spanish | LILACS | ID: biblio-1119497

ABSTRACT

Objetivo: Determinar los beneficios maternos fetales en el manejo conservador de ruptura prematura de membranas ovulares (R.P.M) en embarazadas entre las 34 y 37 semanas de gestación atendidas en el Hospital Bertha Calderón Roque, Managua, Nicaragua, julio - noviembre 2019. Diseño metodológico: Se realizó estudio descriptivo, retrospectivo, de corte transversal, con universo y muestra de 89 pacientes y sus 89 neonatos, con (R.P.M). La información fue tomada de los expedientes clínicos, basado en la construcción de 2 instrumentos que contenían preguntas relacionadas a datos sociodemográficos de las pacientes y antecedentes gineco obstétricos, los criterios para el manejo conservador de la RPM y los posibles elementos de los beneficios maternos y los beneficios fetales. La información fue procesada en sistema estadístico SPSS 21.0 para Windows, representada en tablas y gráficos. El análisis fue de frecuencia simple y porcentajes. Resultados: La edad gestacional de diagnóstico de la RPM fue de 24 a 29sg 66.3%, con 100% de bienestar fetal y sin malformaciones, sin criterios de Gibbs en un 98.9%, se encontró infecciones urinarias y vaginales, obesidad y diabetes en un 43.8%. En el 95.5% sin infección puerperal y la finalización del embarazo fue a las 37 semanas en 89.9% por vía vaginal 86.5%. El peso al nacer fue en 79.7% mayor a 2500 gramos, con recién nacidos sanos 96.6%, con apgar de 8 al minuto en 94.4% y 9 a los 5 minutos 97.8%, sin muerte perinatal en un 100%. Conclusión: Los beneficios maternos más evidentes con el manejo conservador fueron la reducción de incidencia de Cesáreas, prolongación del embarazo disminuyendo riesgo de hemorragia posparto, y disminución de infecciones puerperales lo que permitió mantener la prolongación del embarazo y de esta manera lograr los beneficios fetales, adecuado peso al nacer, con buen APGAR, sin complicaciones, infecciosas, metabólicas y respiratorias


Subject(s)
Humans , Female , Pregnancy , Fetal Membranes, Premature Rupture , Maternal Health , Membranes , Public Health , Epidemiology, Descriptive , Cross-Sectional Studies , Retrospective Studies
9.
Article in English | LILACS | ID: biblio-1057228

ABSTRACT

ABSTRACT Objective: To determine maternal and fetal risk factors associated with the birth of late preterm infants in comparison to those born at term. Methods: A case-control study was carried out in a tertiary center for high-risk pregnancies. For the cases, the study enrolled post-partum mothers and their respective newborns with gestational ages equal or greater than 34 weeks and less than 37 weeks. As controls, the post-partum mothers and their newborns with gestational ages of 37 weeks or greater were selected. The sample was calculated with a ratio of two controls for each case, resulting in 423 patients. Association studies were performed using the chi-square test or Fisher's exact test and logistic regression analysis. Results: The variables associated with late prematurity were inadequate prenatal (Odds Ratio [OR] 1.23; confidence interval of 95% [95%CI] 1.12-1.34; p≤0.001), premature rupture of membranes (OR 4.98; 95%CI 2.66-9.31; p≤0.001), length of hospital stay ≥24 hours until birth (OR 0.18; 95%CI 0.06-0.52; p≤0.001), cesarean section (OR 2.74; 95%CI 1.69-4.44; p≤0.001) and small for gestational age newborn (OR 3.02; 95%CI 1.80-5.05; p≤0.001). Conclusions: Inadequate prenatal care and membranes' premature rupture were found as factors associated with the late preterm birth. It is important to identify the factors that allow intervention with adequate prenatal care in order to reduce poor outcomes due to late prematurity.


RESUMO Objetivo: Determinar fatores maternos e fetais associados ao nascimento de recém-nascidos prematuros tardios, quando comparados aos nascidos a termo. Métodos: Estudo caso-controle em um hospital terciário de referência para atendimento de gestações de alto risco. Foram considerados casos as puérperas e seus respectivos recém-nascidos com idade gestacional maior ou igual a 34 semanas e menor de 37 semanas. Para os controles foram selecionadas as puérperas e seus recém-nascidos com idade gestacional de 37 semanas completas ou mais. A amostra foi calculada com razão de dois controles para cada caso, resultando em um total de 423 pacientes. Estudos de associação foram efetuados utilizando-se o teste do qui-quadrado ou teste exato de Fisher e posterior regressão logística. Resultados: As variáveis associadas à prematuridade tardia foram a realização de pré-natal inadequado (Odds Ratio - OR 1,23; intervalo de confiança de 95% - IC95% 1,12-1,34; p≤0,001), a rotura prematura de membranas amnióticas (OR 4,98; IC95% 2,66-9,31; p≤0,001), o tempo de internação ≥24 horas até o nascimento (OR 0,18; IC95% 0,06-0,52; p≤0,001), o parto operatório (OR 2,74; IC95% 1,69-4,44; p≤0,001) e o recém-nascido pequeno para a idade gestacional (OR 3,02; IC95% 1,80-5,05; p≤0,001). Conclusões: Assistência pré-natal inadequada e rotura prematura de membranas destacaram-se como fatores associados ao nascimento de prematuros tardios. Ressalta-se a relevância da identificação de fatores passíveis de intervenção por meio de adequada assistência pré-natal, a fim de reduzir os desfechos desfavoráveis decorrentes da prematuridade tardia.


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Adolescent , Adult , Young Adult , Prenatal Care/methods , Fetal Membranes, Premature Rupture/epidemiology , Cesarean Section/statistics & numerical data , Premature Birth/epidemiology , Infant, Premature, Diseases/epidemiology , Prenatal Care/trends , Infant, Premature , Infant, Small for Gestational Age , Case-Control Studies , Risk Factors , Gestational Age , Pregnancy, High-Risk , Premature Birth/etiology , Tertiary Care Centers , Length of Stay/trends
10.
San Salvador; s.n; 2020. 29 p.
Thesis in Spanish | LILACS, BISSAL | ID: biblio-1128233

ABSTRACT

La Ruptura Prematura de Membranas (RPM) es la pérdida de la continuidad de las membranas amnióticas con salida de líquido amniótico transvaginal que se presenta antes del inicio del trabajo de parto. La ruptura de las membranas que ocurre prematuramente complica aproximadamente 2 al 3% de todos los embarazos en los Estados Unidos, que representan una proporción significativa de los nacimientos prematuros, mientras que la ruptura prematura de las membranas antes de iniciar el trabajo de parto ocurre en aproximadamente el 8% de los embarazos. Existen dos categorías generales: 1. Ruptura de membranas a término: aquella que ocurre después de las 37 semanas de gestación. 2. Ruptura de membranas pretérmino: la que se presenta antes de las 37 semanas de gestación. Con la finalidad de mejorar la calidad de atención a nuestra población blanco que son mujeres embarazadas con ruptura prematura de membranas se ha elaborado esta guía para estandarizar los procedimientos asistenciales sobre esta patología. Con lo que se pretende realizar una disminución de la incidencia de la ruptura prematura de membranas, diagnóstico oportuno, referencia oportuna y efectiva a cada nivel de atención, prescripción adecuada del tratamiento médico y/o quirúrgico, disminución de la morbi-mortalidad materna y perinatal, disminución en los días de estancia hospitalaria, uso eficiente de recursos con los que se dispone en la institución y lograr obtener la satisfacción de la usuaria con la atención médica y mejora en la calidad de vida.


Subject(s)
Fetal Membranes, Premature Rupture , Obstetrics and Gynecology Department, Hospital
11.
Rev. cient. Esc. Univ. Cienc. Salud ; 6(2): 40-48, jun.-dic. 2019. tab
Article in Spanish | LILACS | ID: biblio-1117910

ABSTRACT

La morbilidad materna y perinatal asociada a la ruptura prematura de membranas constituye un problema social y de salud importante, por lo que es primordial estimar su frecuencia y magnitud. Este artículo condensa las intervenciones de enfermería en paciente con ruptura prematura de membranas aplicando el proceso de atención de enfermería (PAE) orientado en la teoría de Dorothea Orem, la cual basa el autocuidado de acuerdo al nivel de dependencia para aplicar una intervención de enfermería obstétrica. La metodología utilizada es el estudio de caso que describe una patología y manejo de un problema el cual se intervino logrando la salud de la madre y su hijo. Participó una gestante de 19 años, con 29 semanas y 5 días de gestación, al valorarla ofreció información sobre su estado actual y antecedentes. Se realizó diagnóstico mediante prueba de helecho y reflejó ruptura prematura de membrana (RPM) que la llevó al oligoamnios, manifestando altura de fondo uterino (AFU) de 19 cm y amenaza de parto pretérmino (APP). El oligoamnios pone en riesgo el crecimiento adecuado del feto, por no ser un embarazo viable para recurrir a un parto. Se realizarón cuidados de enfermería dependientes, procurando un reposo absoluto; e interdependientes manteniendo un equilibrio hídrico, alimentación adecuada, tratando el estreñimiento, prevención de infección y manejo de la ansiedad que puede repercutir en el sueño y comodidad. La asiduidad de los cuidados de enfermería logra una respuesta positiva, al prologar la etapa de gestación hasta una maduración fetal viable para la vida...(AU)


Subject(s)
Humans , Female , Pregnancy , Adult , Fetal Membranes, Premature Rupture/nursing , Oligohydramnios , Maternal Mortality/trends , Nursing/methods
12.
Gac. méd. Méx ; 155(2): 143-148, mar.-abr. 2019. tab
Article in English, Spanish | LILACS | ID: biblio-1286475

ABSTRACT

Resumen Introducción: Las sustancias relacionadas con los microorganismos involucrados en la enfermedad periodontal puedan llegar a la interfaz materno-fetal por vía hematógena y estimular la contractilidad uterina. Objetivo: Determinar la asociación entre enfermedad periodontal con nacimiento pretérmino. Método: Estudio de casos y controles de 343 embarazadas pretérmino y 686 de término. Se calculó la edad gestacional por fecha de último periodo menstrual y se confirmó con los métodos de Capurro y Ballard. La enfermedad periodontal se diagnosticó por la profundidad del espacio entre la raíz dental y la encía. La asociación fue medida con regresión logística. Resultados: La edad de las madres en los casos fue de 23.8 ± 6.7 años y en los controles de 23.2 ± 6.7 años. La enfermedad periodontal estuvo presente en 66.8 % de los casos y 40.5 % de los controles. Los factores asociados con nacimiento pretérmino fueron enfermedad periodontal (RM = 2.26), antecedente de nacimiento pretérmino (RM = 4.96), embarazo no planeado (RM = 2.15), control prenatal deficiente (RM = 2.53), infección de vías urinarias (RM = 2.22), preeclampsia (RM = 4.49), ruptura prematura de membranas amnióticas (RM = 2.59) y nacer por cesárea (RM = 9.15). Conclusión: La enfermedad periodontal en el embarazo constituyó un factor de riesgo independiente para nacimiento pretérmino.


Abstract Introduction: Substances related to microorganisms involved in periodontal disease can reach the maternal-fetal interface via the hematogenous route and stimulate uterine contractility. Objective: To determine the association between periodontal disease and preterm birth. Method: Case-control study in 343 preterm and 686 full-term pregnant women. Gestational age was calculated based on the date of the last menstrual period and confirmed with Capurro and Ballard methods. Periodontal disease was diagnosed according to the depth of the space between the tooth root and the gum. The association was measured with logistic regression. Results: Maternal age of the cases was 23.8 ± 6.7 years, and 23.2 ± 6.7 in the controls. Periodontal disease was present in 66.8% of cases and 40.5% of controls. The factors associated with preterm birth were periodontal disease (Odds ratio [OR] = 2.26), history of preterm birth (OR = 4.96), unplanned pregnancy (OR = 2.15) poor prenatal control (OR = 2.53), urinary tract infection (OR = 2.22), preeclampsia (OR = 4.49), premature rupture of membranes (OR = 2.59) and caesarean section delivery (OR = 9.15). Conclusion: Periodontal disease in pregnancy was an independent risk factor for preterm birth.


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Adolescent , Adult , Young Adult , Periodontal Diseases/complications , Pregnancy Complications/epidemiology , Premature Birth/epidemiology , Periodontal Diseases/epidemiology , Pre-Eclampsia/epidemiology , Urinary Tract Infections/complications , Urinary Tract Infections/epidemiology , Fetal Membranes, Premature Rupture/epidemiology , Case-Control Studies , Cesarean Section/statistics & numerical data , Risk Factors , Mexico
13.
Neonatal Medicine ; : 48-54, 2019.
Article in Korean | WPRIM | ID: wpr-741664

ABSTRACT

PURPOSE: To analyze and compare the clinical factors and neurodevelopmental outcomes compare early- and late-onset periventricular leukomalacia (PVL) in very low birth weight infants (VLBWI). METHODS: We performed a retrospective study involving 199 newborn infants weighing < 1,500 g admitted to the neonatal intensive care unit between March 2009 and December 2015. VLBWI with PVL were categorized into early- and late-onset PVL groups based on the time of diagnosis based on 28 days of age. We analyzed the clinical factors and neurodevelopmental outcomes between the groups. RESULTS: The incidence rate of PVL was 10.1% (16/158). The Apgar score at 1 minute and the mean duration of tocolytic therapy were associated with the development of PVL. The incidence rate of premature rupture of membranes (PROM) was significantly higher in the early-onset PVL group (P=0.041). No significant differences were observed in neurodevelopmental outcomes between the early- and late-onset PVL groups. CONCLUSION: Results suggest that a higher incidence of PROM was associated with clinical characteristics in the early-onset PVL group. No significant intergroup differences were observed in neurodevelopmental outcomes; however, the Bayley Scales of Infant Development-III scores were lower in the early-onset PVL group.


Subject(s)
Apgar Score , Diagnosis , Female , Fetal Membranes, Premature Rupture , Humans , Incidence , Infant , Infant, Newborn , Infant, Very Low Birth Weight , Intensive Care, Neonatal , Leukomalacia, Periventricular , Membranes , Pregnancy , Retrospective Studies , Rupture , Tocolysis , Weights and Measures
14.
Article in French | AIM, AIM | ID: biblio-1271852

ABSTRACT

L'objectif était d'étudier les différents aspects de la rupture prématurée des membranes dans un contexte de pays à ressources limitées. Il s'est agi d'une étude prospective et descriptive à visée analytique, sur une période de 12 mois, dans le département de Gynécologie, d'Obstétrique et de Médecine de la Reproduction du Centre Hospitalier Universitaire Souro Sanou de Bobo-Dioulasso au Burkina Faso. Elle a concerné les gestantes reçues dans notre département chez qui le diagnostic de rupture prématurée des membranes (RPM), sur des grossesses de 28 à 34 semaines d'aménorrhée, a été confirmé à l'issue de l'examen clinique. Nous avons enregistré 38 cas de rupture prématurée des membranes pour 5024 accouchements soit une fréquence de 0,75 %. Ces gestantes étaient surtout jeunes, primipares, femmes au foyer, non alphabétisées, ayant fait peu de consultations prénatales. Les antécédents de ces patientes ont été marqués par des cas de ruptures prématurées des membranes et d'avortement. Ces patientes présentaient en outre soit des infections urogénitales, des présentations irrégulières, des distensions utérines et/ ou un placenta prævia. Cela nous a permis ainsi d'identifier un groupe de femmes que l'on pourrait dans une certaine mesure qualifier de groupe à risque de rupture prématurée des membranes dans notre département. La présence de certains éléments cliniques et paracliniques chez ces patientes, nous a permis d'identifier ce qu'on pourrait appeler des femmes à risque de rupture prématurée des membranes


Subject(s)
Academic Medical Centers , Amenorrhea , Burkina Faso , Fetal Membranes, Premature Rupture , Office Visits , Pregnancy Trimester, Third , Risk Factors
15.
Clinics ; 74: e1231, 2019. tab, graf
Article in English | LILACS | ID: biblio-1039554

ABSTRACT

OBJECTIVE: To perform a descriptive analysis of preterm premature rupture of membranes (PPROM) cases attended in a tertiary hospital. METHOD: Retrospective analysis of medical records and laboratory tests of patients admitted to a Brazilian tertiary hospital between 2006 and 2011, with a confirmed diagnosis of PPROM and gestational age (GA) at delivery <37 weeks. RESULTS: A total of 299 pregnant women were included in the study. Nine patients evolved to abortion, and 290 pregnant women remained for the final analysis. There was initial diagnostic doubt in 17.6% of the cases. The oligohydramnios rate [amniotic fluid index (AFI) <5] was 27.9% on admission. Chorioamnionitis was initially diagnosed in 10.8% of the patients and was retrospectively confirmed in 22.9% of the samples. The latency period had a mean of 9.1 days. The main reasons for interruption were premature labor (55.2%), GA ≥36 weeks (27.2%), and fetal distress (6.9%). The delivery method was cesarean section in 55% of cases. The mean birth weight was 2,124 grams, and 67% of the neonates had a low birth weight (<2500 g). The GA at delivery averaged 33.5 weeks. The stillbirth rate was 5.3%, and the early neonatal mortality rate was 5.6%. There were complications at delivery in 18% of mothers. CONCLUSION: In one of the few Brazilian reports on the epidemiological profile of PPROM, with GA until 37 weeks and intercurrences generally excluded from assessments (such as twinning and fetal malformations), there is a favorable evolution, with an acceptable rate of complications.


Subject(s)
Humans , Female , Infant, Newborn , Infant , Adolescent , Adult , Young Adult , Fetal Membranes, Premature Rupture/epidemiology , Birth Weight , Brazil/epidemiology , Pregnancy Outcome , Infant Mortality , Retrospective Studies , Chorioamnionitis/epidemiology , Gestational Age , Tertiary Care Centers
16.
Rev. bras. ginecol. obstet ; 40(12): 733-739, Dec. 2018. tab, graf
Article in English | LILACS | ID: biblio-977802

ABSTRACT

Abstract Objective To determine the role of caspase-3, apoptosis-inducing factor (AIF), and Bcell lymphoma-2 (Bcl-2) expressions in term premature rupture of membrane (PROM). Methods An analytic observational study with case-control design was conducted, involving 52 subjects (37-42 weeks of gestation) who were divided into 2 groups: 26 cases of term delivery with PROM, and 26 controls of term delivery without PROM. The expressions of caspase-3, AIF, and Bcl-2 in the amniotic membrane were determined by immunohistochemistry. Data were analyzed using the chi-squared test. The risk of PROM was expressed by odds ratio (OR). Results There were no significant differences in age, parity and body mass index between the two groups (p > 0.05). High caspase-3 and AIF expressions increased the risk of PROM 17.64 times (OR = 17.64; 95% CI = 4.44-70.07; p = 0.001) and 9.45 times (OR = 9.45; 95% CI= 2.62-34.07; p = 0.001), respectively, while low Bcl-2 expression increased 10.39 times (OR = 10.39; 95% CI = 2.73-39.56; p = 0.001)the risk of PROM . Conclusion High caspase-3 and AIF expressions and low Bcl-2 expression were risk factors for term PROM. Caspase-dependent and independent pathways of apoptosis were involved in the mechanism of PROM in term pregnancy.


Subject(s)
Humans , Female , Pregnancy , Adult , Fetal Membranes, Premature Rupture/metabolism , Proto-Oncogene Proteins c-bcl-2/biosynthesis , Apoptosis Inducing Factor/biosynthesis , Caspase 3/biosynthesis , Case-Control Studies
17.
Rev. Assoc. Med. Bras. (1992) ; 64(10): 888-895, Oct. 2018. tab, graf
Article in English | LILACS | ID: biblio-976782

ABSTRACT

SUMMARY BACKGROUND: To determine the concentration of the Lipid Peroxidation Marker: Malondialdehyde (MDA), and Antioxidant Markers: Superoxide Dismutase (SOD), Glutathione Peroxidase (GPX), Catalase (CAL) in umbilical cord blood and in unstimulated saliva in the first 24 and 48 hours of life in the PTNB of mothers with and without risk factors for early-onset neonatal sepsis. METHODS: Cross-sectional study with the signing of informed consent by the pregnant women and application of a standard questionnaire classifying the PTNB in Group 1 or 2. RESULTS: Twenty-one PTNB were studied. Regarding gender, birth weight, need for oxygen, use of phototherapy, diagnosis of assumed sepsis, presence of fetal distress, number of pregnancies, type of delivery, use of corticosteroids, premature rupture of membranes, maternal fever, chorioamnionitis, APGAR at the 5th and 10th minute of life. Statistical analysis was performed with the Mann-Whitney test (p = 0.019) on the GPX variable of umbilical cord blood in the group of mothers with risk factors for early-onset neonatal sepsis. There was no statistical difference in the MDA, SOD, and CAT variables of the group with risk factors and in any variable of the group without risk factors. CONCLUSION: There was an increase of the GPX concentration in the blood from the umbilical vein in the group with risk factors for early-onset neonatal sepsis. There was no statistical significance in the comparison of saliva and umbilical cord blood. There was no statistically significant difference in MDA, SOD, CAT.


RESUMO OBJETIVOS: Determinar a concentração do marcador de peroxidação lipídica: Malondialdeído (MDA) e dos marcadores antioxidantes: Superóxido Dismutase (SOD), Glutationa Peroxidase (GPX), Catalase (CAL) no sangue do cordão umbilical e na saliva não estimulada nas primeiras 24 e 48 horas de vida nos RNPT de mães com e sem fatores de risco para sepse neonatal precoce. METODOLOGIA: Estudo transversal com a assinatura do termo de consentimento livre esclarecido pela gestante e aplicação de um questionário padrão classificando o RNPT no Grupo 1 ou 2. RESULTADOS: Foram estudados 21 RNPT. Quanto ao gênero, peso ao nascimento, necessidade de oxigênio, uso de fototerapia, diagnóstico de sepse presumida, presença de sofrimento fetal, número de gestações, tipo de parto, uso de corticoide, rotura prematura de membranas, a presença de febre materna, a presença de corioamnionite, Apgar no 50 e 100 minuto de vida, a análise estatística foi feita com o teste de Mann-Whitney (p=0,019) na váriável GPX do sangue do cordão umbilical no grupo das mães com fatores de risco para sepse neonatal precoce. Não houve diferença estatística nas outras variáveis MDA, SOD, CAT do grupo com fatores de risco e em nenhuma variável do grupo sem fatores de risco. CONCLUSÃO: O aumento de duas vezes a concentração da GPX no sangue da veia umbilical dos RNPT do grupo das mães com fatores de risco para sepse neonatal precoce. Sem significância estatística na comparação entre a saliva e o sangue do cordão umbilical. Não houve diferença estatisticamente significante nas variáveis MDA, SOD e CAT.


Subject(s)
Humans , Male , Female , Pregnancy , Infant, Newborn , Biomarkers/analysis , Fetal Blood/chemistry , Neonatal Sepsis/diagnosis , Saliva/chemistry , Superoxide Dismutase/analysis , Fetal Membranes, Premature Rupture , Infant, Premature , Catalase/analysis , Cross-Sectional Studies , Risk Factors , Neonatal Sepsis/metabolism , Glutathione Peroxidase/analysis , Malondialdehyde/analysis , Antioxidants/analysis , Antioxidants/metabolism
18.
Rev. Eugenio Espejo ; 12(1): 53-63, Jun.- 2018.
Article in Spanish | LILACS | ID: biblio-980680

ABSTRACT

Se realizó un estudio observacional, de tipo descriptivo y corte transversal con enfoque mixto; cuyo objetivo de determinar los factores de riesgo de ruptura prematura de membra-nas en las pacientes ingresadas con ese diagnóstico en el Hospital Provincial General Docen-te Riobamba durante el período noviembre 2017-febrero 2018. Se trabajó con la totalidad de la población, la que estuvo integrada por 17 embarazadas en el contexto de investigación. Se aplicó una guía de entrevista estructurada la misma que fue sometida a valoración por espe-cialistas integrado por siete docentes vinculadas a las tutorías de prácticas preprofesionales en el área del Proceso de Atención de Enfermería en Salud Sexual y Reproductiva de la Universidad Nacional de Chimborazo; el 85,71 % de las consultadas consideraron el instru-mento como muy adecuado. El 52,94 % de las mujeres estudiadas fue mayor de 26 años, tenía estado civil casadas y nivel de instrucción de secundaria. El factor clínico más relevante fue infecciones de vías urinarias y cérvico-vaginales durante el embarazo; sin embargo, entre los obstétricos fueron los controles obstétricos escasos y el oligoamnios. Los datos arrojaron la ausencia de aquellos relativos a ser víctima de violencia familiar, consumo de sustancias tóxicas, auto medicación, relaciones sexuales durante los últimos 15 días del embarazo, tacto vaginal y/o amniocentesis en las horas previas a la presentación de la entidad en cuestión, embarazo múltiple, antecedentes personales de RPM, incompetencia del cérvix y polihi-dramnios.


An observational, descriptive and cross-sectional study with a mixed approach was carried out. This research aimed to determine the risk factors for premature rupture of membranes in patients admitted with this diagnosis in the General Hospital of Riobamba during the period November 2017-February 2018. The entire population was integrated by 17 pregnant women in the research context. A structured interview guide was applied, which was assessed by seven specialists who worked at pre-professional practice tutoring in the area of the Nursing Care Process in Sexual and Reproductive Health of Universidad Nacional de Chimborazo; the instrument was considered as very adequate by 85.71% of interviewed ones. 52.94% of the women studied were over 26 years of age, married, and high school education level. The most relevant clinical factor was urinary tract and cervico-vaginal infections during pregnan-cy. However, the obstetric factors were the controls in this field and oligohydramnios. The data showed the absence of those ones related to being a victim of family violence, consump-tion of toxic substances, self-medication, sexual intercourse during the last 15 days of preg-nancy, vaginal touch and / or amniocentesis in the hours prior to the presentation of the entity in question , multiple pregnancy, personal history of RPM, incompetence of the cervix and polyhydramnios.


Subject(s)
Humans , Female , Pregnancy , Pregnancy Complications , Fetal Membranes, Premature Rupture , Standardized Nursing Terminology , Urinary Tract Infections , Obstetrics and Gynecology Department, Hospital , Uterine Cervical Diseases , Risk Factors , Amniocentesis
19.
Article in English | WPRIM | ID: wpr-714700

ABSTRACT

The latency in preterm premature rupture of membranes (PPROM) can last for weeks. We describe an extremely rare case of hand prolapse with PPROM that was exposed for 23 days before delivery. The patient had spontaneous PPROM of twin A at 21.4 weeks of gestation with shoulder presentation. The right arm of the fetus eventually protruded out the vagina and the hand was exposed for extended period of time of 23 days until delivery. Daily dressing by applying collagen to dry skin and silicone to keep moisture was done to the protruding hand to prevent dehydration and desquamation of the skin. Prophylactic antibiotics were used and the patient underwent emergent cesarean section due to uncontrolled preterm labor at 25.2 weeks. To the best of our knowledge, this is the first case of hand prolapse of one twin with extended period of latency before delivery.


Subject(s)
Anti-Bacterial Agents , Arm , Bandages , Cesarean Section , Collagen , Dehydration , Female , Fetal Membranes, Premature Rupture , Fetus , Hand , Humans , Labor Presentation , Membranes , Obstetric Labor, Premature , Pregnancy , Pregnancy, Twin , Prolapse , Rupture , Shoulder , Silicon , Silicones , Skin , Twins , Vagina
20.
ARS med. (Santiago, En línea) ; 43(1): 20-24, 2018. Tab
Article in Spanish | LILACS | ID: biblio-1022454

ABSTRACT

Introducción: La rotura prematura ovular (RPO) antes de la viabilidad fetal consiste en una complicación obstétrica de baja incidencia, pero de alta morbimortalidad perinatal asociada. Estudios sugieren que el volumen de líquido amniótico (LA) es un factor importante a considerar. El objetivo de este trabajo es evaluar si en RPO ≤24 semanas, un bolsillo vertical máximo (BVM) <2cm al diagnóstico es un factor de riesgo para aparición de morbimortalidad fetal y neonatal. Métodos: Estudio de cohorte longitudinal retrospectivo de 94 pacientes con RPO ≤24 semanas ingresadas a un hospital terciario para manejo expectante entre los años 2005 y 2014. Embarazo gemelar o malformaciones congénitas fueron criterios de exclusión. Se obtuvieron y compararon 2 grupos según BVM al ingreso (BVM ≥ 2 cm y BVM < a 2 cms) y se comparó la edad gestacional (EG) al momento de la RPO y al parto, la latencia desde la RPO al parto, la presencia de corioamnionitis clínica, el número de óbitos fetales, muerte neonatal precoz (primeros 7 días de vida), tardía (entre los 7 y 28 días) y sobrevida global. Resultados: El 58 por ciento de las pacientes presentó un BVM <2 cm al ingreso, el cual se asoció a menor latencia al parto (p:0,01), menor EG al parto (p:0,02), más óbito fetal (p:0,04), mayor muerte neonatal precoz y tardía (p:0,02 y 0,01 respectivamente) además de menor sobrevida global (p:0,01). Conclusiones: La medición de BVM <2 cm al ingreso en pacientes con RPO ≤24 semanas, es un factor de mal pronóstico y debe ser considerado en el manejo clínico de estas pacientes.(AU)


Introduction: Previable premature rupture of membranes (pPROM) is a low-incidence obstetric complication associated with high perinatal morbidity and mortality. Studies suggest that the volume of amniotic fluid (AL) is an important factor to consider. The aim of this study is to evaluate if in RPO ≤24 weeks, a maximum vertical pocket (MVP) <2 cm to the diagnostic is a risk factor for fetal and neonatal morbidity and mortality. Objectives: Evaluate fetal and neonatal morbidity and mortality according to amniotic fluid (AL) Maximum Vertical Pocket (MVP) ≥ or

Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Fetal Membranes, Premature Rupture , Infant, Newborn, Diseases , Morbidity , Perinatal Care
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