RESUMO
OBJECTIVE: The aim of our study was to define he best delay for management of spontaneous rupture of the membranes at term. MATERIALS AND METHODS: We conducted a prospective multicentric study in western France defining 3 groups of expectancy (6, 12 and 24 hours) to assess obstetrical, neonatal and maternal outcomes. RESULTS: We included 713 patients. There was no significant difference in neonatal and maternal morbidity between the 3 groups. The rate of cesarean section was statistically higher in the 6-hour group (12%). There was no statistical difference between 12 and 24 hours but the rate was lower in the 12-hour group (5.5 versus 7.9%). CONCLUSION: Based on our findings and a review of the literature, we have decided that in cased of premature rupture of the membranes at term, a 12 hour delay is best. At most two prostaglandin maturations can be performed in unfavorable cervixes.
Assuntos
Ruptura Prematura de Membranas Fetais/terapia , Trabalho de Parto Induzido/métodos , Adulto , Cesárea/normas , Cesárea/estatística & dados numéricos , Protocolos Clínicos/normas , Feminino , Ruptura Prematura de Membranas Fetais/complicações , Ruptura Prematura de Membranas Fetais/diagnóstico , França/epidemiologia , Humanos , Trabalho de Parto Induzido/normas , Trabalho de Parto Induzido/estatística & dados numéricos , Morbidade , Seleção de Pacientes , Gravidez , Resultado da Gravidez/epidemiologia , Prognóstico , Estudos Prospectivos , Fatores de TempoRESUMO
The present data show that the contraceptive studied, a triphasic combination pill with gestodene, strongly depresses gonadotropin levels. Seric levels of both FSH and LH are below 1 mIU/ml as early as the third treatment cycle. Recovery of a normal pituitary function occurs rapidly after the administration is discontinued: both basal and stimulated gonadotropin levels are back to normal during the first cycle following a 3 months treatment course. Prolactin secretion remains unaltered both during and after treatment.