Expectant Management of Preterm Ruptured Membranes: Effects of Antimicrobial Therapy
OBJECTIVE:To determine whether the addition of broadspectrum antimicrobial therapy to traditional expectant management improves pregnancy outcome in patients with premature rupture of membranes (PROM) remote from term. METHODS:Patients with preterm PROM before 34 weeksʼ gestation who were not in lab...
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| Veröffentlicht in: | Obstetrics and gynecology (New York. 1953) 1992-11, Vol.80 (5), p.759-762 |
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| container_title | Obstetrics and gynecology (New York. 1953) |
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| creator | CHRISTMAS, JAMES T COX, SUSAN M ANDREWS, WILLIAM DAX, JODY LEVENO, KENNETH J GILSTRAP, LARRY C |
| description | OBJECTIVE:To determine whether the addition of broadspectrum antimicrobial therapy to traditional expectant management improves pregnancy outcome in patients with premature rupture of membranes (PROM) remote from term.
METHODS:Patients with preterm PROM before 34 weeksʼ gestation who were not in labor and had no signs of infection or fetal distress were randomized to one of two study groups1) expectant management alone and 2) expectant management plus antimicrobial therapy. Women in the latter group received intravenous ampicillin, gentamicin, and clindamycin for 24 hours, followed by amoxicillin plus clavulanic acid orally for 7 days. Other than antibiotic use, management of the two groups was identical.
RESULTS:Significantly more women (P |
| format | Article |
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METHODS:Patients with preterm PROM before 34 weeksʼ gestation who were not in labor and had no signs of infection or fetal distress were randomized to one of two study groups1) expectant management alone and 2) expectant management plus antimicrobial therapy. Women in the latter group received intravenous ampicillin, gentamicin, and clindamycin for 24 hours, followed by amoxicillin plus clavulanic acid orally for 7 days. Other than antibiotic use, management of the two groups was identical.
RESULTS:Significantly more women (P <.01) treated with antibiotics (20 of 48,42%) remained undelivered 7 days after admission compared with those managed expectantly without antibiotics (seven of 46, 15%). In addition, more neonates in the group managed with antibiotics were admitted to the routine nursery (nine of 48 versus two of 45; P =.03). However, there was no difference between the groups in the frequency of serious maternal or neonatal morbidity.
CONCLUSION:The addition of broad-spectrum antimicrobial therapy to traditional expectant management of pregnancy complicated by preterm PROM may increase the number of gestations undelivered 7 days after admission. It may also decrease the proportion of infants, admitted to special care nurseries. Whether these effects result in significant short- or long-term maternal or neonatal benefit remains to be determined.</description><identifier>ISSN: 0029-7844</identifier><identifier>EISSN: 1873-233X</identifier><identifier>PMID: 1407911</identifier><identifier>CODEN: OBGNAS</identifier><language>eng</language><publisher>New York, NY: The American College of Obstetricians and Gynecologists</publisher><subject>Anti-Bacterial Agents ; Biological and medical sciences ; Diseases of mother, fetus and pregnancy ; Drug Therapy, Combination - therapeutic use ; Female ; Fetal Membranes, Premature Rupture - complications ; Gynecology. Andrology. Obstetrics ; Humans ; Medical sciences ; Pregnancy ; Pregnancy Complications, Infectious - etiology ; Pregnancy Complications, Infectious - prevention & control ; Pregnancy Outcome ; Pregnancy Trimester, Second ; Pregnancy Trimester, Third ; Pregnancy. Fetus. Placenta</subject><ispartof>Obstetrics and gynecology (New York. 1953), 1992-11, Vol.80 (5), p.759-762</ispartof><rights>1992 The American College of Obstetricians and Gynecologists</rights><rights>1993 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=4385456$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/1407911$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>CHRISTMAS, JAMES T</creatorcontrib><creatorcontrib>COX, SUSAN M</creatorcontrib><creatorcontrib>ANDREWS, WILLIAM</creatorcontrib><creatorcontrib>DAX, JODY</creatorcontrib><creatorcontrib>LEVENO, KENNETH J</creatorcontrib><creatorcontrib>GILSTRAP, LARRY C</creatorcontrib><title>Expectant Management of Preterm Ruptured Membranes: Effects of Antimicrobial Therapy</title><title>Obstetrics and gynecology (New York. 1953)</title><addtitle>Obstet Gynecol</addtitle><description>OBJECTIVE:To determine whether the addition of broadspectrum antimicrobial therapy to traditional expectant management improves pregnancy outcome in patients with premature rupture of membranes (PROM) remote from term.
METHODS:Patients with preterm PROM before 34 weeksʼ gestation who were not in labor and had no signs of infection or fetal distress were randomized to one of two study groups1) expectant management alone and 2) expectant management plus antimicrobial therapy. Women in the latter group received intravenous ampicillin, gentamicin, and clindamycin for 24 hours, followed by amoxicillin plus clavulanic acid orally for 7 days. Other than antibiotic use, management of the two groups was identical.
RESULTS:Significantly more women (P <.01) treated with antibiotics (20 of 48,42%) remained undelivered 7 days after admission compared with those managed expectantly without antibiotics (seven of 46, 15%). In addition, more neonates in the group managed with antibiotics were admitted to the routine nursery (nine of 48 versus two of 45; P =.03). However, there was no difference between the groups in the frequency of serious maternal or neonatal morbidity.
CONCLUSION:The addition of broad-spectrum antimicrobial therapy to traditional expectant management of pregnancy complicated by preterm PROM may increase the number of gestations undelivered 7 days after admission. It may also decrease the proportion of infants, admitted to special care nurseries. Whether these effects result in significant short- or long-term maternal or neonatal benefit remains to be determined.</description><subject>Anti-Bacterial Agents</subject><subject>Biological and medical sciences</subject><subject>Diseases of mother, fetus and pregnancy</subject><subject>Drug Therapy, Combination - therapeutic use</subject><subject>Female</subject><subject>Fetal Membranes, Premature Rupture - complications</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Humans</subject><subject>Medical sciences</subject><subject>Pregnancy</subject><subject>Pregnancy Complications, Infectious - etiology</subject><subject>Pregnancy Complications, Infectious - prevention & control</subject><subject>Pregnancy Outcome</subject><subject>Pregnancy Trimester, Second</subject><subject>Pregnancy Trimester, Third</subject><subject>Pregnancy. Fetus. Placenta</subject><issn>0029-7844</issn><issn>1873-233X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1992</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9kNtKAzEQhoMotVYfQdgL8W4h5028K1IP0KJIBe-WbHZiV_dkskvt2xttEQbm9M0w8x-hKVEZSyljb8doijHVaaY4P0VnIXxgjInUbIImhONMEzJF68V3D3Yw7ZCsTGveoYEYdi559jCAb5KXsR9GD2WygqbwpoVwkyycizPhF5u3Q9VU1ndFZepkvQFv-t05OnGmDnBx8DP0erdY3z6ky6f7x9v5Mu2pwjKlXHMO3GohlSszaQtNMC1JtIxIprh0FhcZWFuUlolSuFILRQTjVjhNDZuh6_3e3ndfI4Qhb6pgoa7jmd0Y8oxRiRVhEbw8gGPRQJn3vmqM3-UHGWL_6tA3wZraxT9tFf4xzpTgQkaM77FtV0dxwmc9bsHnGzD1sMmjulhSgVOiNSUkZulfif0Afxd2IA</recordid><startdate>199211</startdate><enddate>199211</enddate><creator>CHRISTMAS, JAMES T</creator><creator>COX, SUSAN M</creator><creator>ANDREWS, WILLIAM</creator><creator>DAX, JODY</creator><creator>LEVENO, KENNETH J</creator><creator>GILSTRAP, LARRY C</creator><general>The American College of Obstetricians and Gynecologists</general><general>Elsevier Science</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>199211</creationdate><title>Expectant Management of Preterm Ruptured Membranes: Effects of Antimicrobial Therapy</title><author>CHRISTMAS, JAMES T ; COX, SUSAN M ; ANDREWS, WILLIAM ; DAX, JODY ; LEVENO, KENNETH J ; GILSTRAP, LARRY C</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p2806-24944e4c9568fd76cb9102d12d17163846fc0b7eccbdc35d5fd9581534c5f92a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1992</creationdate><topic>Anti-Bacterial Agents</topic><topic>Biological and medical sciences</topic><topic>Diseases of mother, fetus and pregnancy</topic><topic>Drug Therapy, Combination - therapeutic use</topic><topic>Female</topic><topic>Fetal Membranes, Premature Rupture - complications</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Humans</topic><topic>Medical sciences</topic><topic>Pregnancy</topic><topic>Pregnancy Complications, Infectious - etiology</topic><topic>Pregnancy Complications, Infectious - prevention & control</topic><topic>Pregnancy Outcome</topic><topic>Pregnancy Trimester, Second</topic><topic>Pregnancy Trimester, Third</topic><topic>Pregnancy. Fetus. Placenta</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>CHRISTMAS, JAMES T</creatorcontrib><creatorcontrib>COX, SUSAN M</creatorcontrib><creatorcontrib>ANDREWS, WILLIAM</creatorcontrib><creatorcontrib>DAX, JODY</creatorcontrib><creatorcontrib>LEVENO, KENNETH J</creatorcontrib><creatorcontrib>GILSTRAP, LARRY C</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>Obstetrics and gynecology (New York. 1953)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>CHRISTMAS, JAMES T</au><au>COX, SUSAN M</au><au>ANDREWS, WILLIAM</au><au>DAX, JODY</au><au>LEVENO, KENNETH J</au><au>GILSTRAP, LARRY C</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Expectant Management of Preterm Ruptured Membranes: Effects of Antimicrobial Therapy</atitle><jtitle>Obstetrics and gynecology (New York. 1953)</jtitle><addtitle>Obstet Gynecol</addtitle><date>1992-11</date><risdate>1992</risdate><volume>80</volume><issue>5</issue><spage>759</spage><epage>762</epage><pages>759-762</pages><issn>0029-7844</issn><eissn>1873-233X</eissn><coden>OBGNAS</coden><abstract>OBJECTIVE:To determine whether the addition of broadspectrum antimicrobial therapy to traditional expectant management improves pregnancy outcome in patients with premature rupture of membranes (PROM) remote from term.
METHODS:Patients with preterm PROM before 34 weeksʼ gestation who were not in labor and had no signs of infection or fetal distress were randomized to one of two study groups1) expectant management alone and 2) expectant management plus antimicrobial therapy. Women in the latter group received intravenous ampicillin, gentamicin, and clindamycin for 24 hours, followed by amoxicillin plus clavulanic acid orally for 7 days. Other than antibiotic use, management of the two groups was identical.
RESULTS:Significantly more women (P <.01) treated with antibiotics (20 of 48,42%) remained undelivered 7 days after admission compared with those managed expectantly without antibiotics (seven of 46, 15%). In addition, more neonates in the group managed with antibiotics were admitted to the routine nursery (nine of 48 versus two of 45; P =.03). However, there was no difference between the groups in the frequency of serious maternal or neonatal morbidity.
CONCLUSION:The addition of broad-spectrum antimicrobial therapy to traditional expectant management of pregnancy complicated by preterm PROM may increase the number of gestations undelivered 7 days after admission. It may also decrease the proportion of infants, admitted to special care nurseries. Whether these effects result in significant short- or long-term maternal or neonatal benefit remains to be determined.</abstract><cop>New York, NY</cop><pub>The American College of Obstetricians and Gynecologists</pub><pmid>1407911</pmid><tpages>4</tpages></addata></record> |
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| subjects | Anti-Bacterial Agents Biological and medical sciences Diseases of mother, fetus and pregnancy Drug Therapy, Combination - therapeutic use Female Fetal Membranes, Premature Rupture - complications Gynecology. Andrology. Obstetrics Humans Medical sciences Pregnancy Pregnancy Complications, Infectious - etiology Pregnancy Complications, Infectious - prevention & control Pregnancy Outcome Pregnancy Trimester, Second Pregnancy Trimester, Third Pregnancy. Fetus. Placenta |
| title | Expectant Management of Preterm Ruptured Membranes: Effects of Antimicrobial Therapy |
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