RESUMO
This study aimed to assess outcomes of expectant management for early preterm premature rupture of membranes (PPROM). This retrospective cohort involved 66 women with PPROM <28 weeks managed in a single hospital (1999-2006). Main outcomes were chorioamnionitis, severe maternal morbidity (maternal sepsis, haemorrhage/blood transfusion, hysterectomy or admission to intensive care unit), maternal mortality, low birth weight, preterm birth, neonatal infection and perinatal mortality. Mean gestational ages at PPROM and delivery were 21.7 ± 4.2 and 28.4 ± 5.9 weeks, respectively. Chorioamnionitis was diagnosed in 47%; no cases of severe maternal morbidity or mortality occurred. Stillbirth rate was 25.7% and >80% of infants were delivered before 34 weeks. Neonatal infection was diagnosed in 42.9% of the 49 live-births. Overall survival rate was 57.6%. Expectant management of PPROM <28 weeks resulted in high rates of chorioamnionitis and preterm deliveries but in over half of the cases, a live infant was discharged home.
Assuntos
Países em Desenvolvimento , Ruptura Prematura de Membranas Fetais/epidemiologia , Resultado da Gravidez , Adulto , Brasil/epidemiologia , Feminino , Humanos , Gravidez , Estudos RetrospectivosRESUMO
OBJECTIVE: Compare the use of a newly designed and reusable metal trocar for initial uterine entry with the disposable Tulipan-Bruner trocar in creation of a hysterotomy for fetal surgery. METHODS: Six consecutive patients undergoing hysterotomy for intrauterine repair of myelomeningocele were randomized to uterine entry either with the Tulipan-Bruner trocar or with the Almodin-Moron trocar. Blood loss was estimated by the primary surgeon. RESULTS: There was no statistically significant difference in the uterine entry times between the trocars. Blood loss was estimated to be approximately the same. The Almodin-Moron trocar was judged to provide easy handling with good safety. CONCLUSIONS: The Almodin-Moron trocar provides a uterine entry during creation of a hysterotomy that is as quick and causes as little trauma as the Tulipan-Bruner trocar.
