: To compare the perinatal outcome and delivery intervals after the induction of labour with the Prostin vaginal tablet versus the Propess vaginal system in pregnant women with term-PROM.
: One ...centre paralleled randomised controlled trial with a computer-generated table to allocate treatments.
: University Medical Centre in Slovenia.
: A total of 205 singleton healthy pregnant women with term-PROM.
: Induction of labour with the Propess vaginal system (intervention group) versus Prostin tablets (control group).
: The rate of failed inductions, complications in labour, time intervals between the PROM, induction, the beginning of the active phase, and delivery.
: A total of 104 patients received Prostin, and 101 patients received Propess. Induction failure rates in the Prostin and the Propess groups were 8/104 (7.7%) and 5/101 (5.0%), respectively (
= 0.80). Delivery abnormalities were uncommon and comparable across the groups. The rates of caesarean sections in the Prostin and Propess groups were 4/96 (4.2%) and 6/96 (6.3%), respectively. The delivery intervals were comparable across the groups.
: In term-PROM pregnancies, the Propess vaginal system is a safe and effective option for inducing labour.
Spontaneous rupture of membranes before the onset of labor at term is commonly referred to as PROM (either premature or preterm rupture of membranes) and occurs in about 8% of term pregnancies. PROM ...is associated with an increased risk of infection. Many controversies exist regarding the optimal management of PROM, including the choice of induction or expectant management, use of digital vaginal exams, and routine administration of antibiotics. This article reviews the literature on PROM and illustrates some of the management issues encountered by presenting approaches used in three midwifery services.
Full text
Available for:
BFBNIB, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, UL, UM, UPUK, VSZLJ
L’accouchement du siège par voie basse fait toujours débat dans la littérature. À cette situation obstétricale polémique, peut s’ajouter une rupture prématurée des membranes (RPM) alors même que les ...sièges sont classiquement exclus des études traitant des RPM. Pour certains, cette RPM associée à la présentation du siège devient une indication de césarienne. L’objectif de ce travail était d’évaluer le pronostic obstétrical des présentations podaliques à terme en cas de rupture des membranes avant travail.
Nous avons réalisé une étude observationnelle rétrospective, dans notre maternité de niveau 3, entre le 1er janvier 2008 et le 31 décembre 2012. Les groupes étaient constitués de patientes à terme, avec un fœtus en siège, répartis selon l’existence ou non d’une RPM. Le critère de jugement principal était le mode d’accouchement : par césarienne ou voie basse. Les autres critères étudiés étaient les caractéristiques maternelles, le mode de mise en travail et les critères de bien être néonatal.
Deux cent neuf patientes ont été incluses. Dans le groupe témoin, on retrouvait 67,9 % d’accouchements voie basse versus 60 % dans le groupe cas, sans différence significative (p=0,25). Aucune différence n’était retrouvée concernant les critères néonataux tels que le pH, les lactates artériels au cordon ombilical, ainsi que le score d’Apgar à 5minutes.
Il apparaît dans nos pratiques qu’une RPM avant travail ne modifie pas le pronostic obstétrical des présentations podaliques à terme et ne soit pas une indication de césarienne systématique en cas de siège.
Breech delivery is still a controversial situation in literature. Added complexity exists when breech presentations are associated with premature rupture of membranes (PROM) as such cases are conventionally excluded in studies dealing with PROM and are often indications for elective caesarean section. Thus, the objective of this study was to evaluate the obstetrical prognosis of breech presentations after PROM at term.
We conducted a retrospective observational study at the Besançon University Medical Centre, between 1st January 2008 and 31th December 2012. Two groups of patients with breech presentations at term were constituted according to the existence or not of a PROM. The primary endpoint was the delivery mode: caesarean section or vaginal. Other endpoints were maternal characteristics, type of onset of labour and neonatal criterias.
Two hundred and nine patients were included. In the control group, 67.9 % of vaginal deliveries occurred versus 60 % in the group with PROM (P=0.25). No difference was found on neonatal criterias such as pH, lactate and the Apgar score at 5 minutes.
PROM at term in breech presentation doesn’t seem to change the obstetrical prognosis and should therefore not be a systematic indication for elective caesarean section.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
We hypothesize that expectant management in the presence of premature rupture of membranes at term would result in a lower cesarean birth rate with no increase in maternal, fetal, or neonatal ...infection.
Term patients who consented to the study were randomly allocated either to expectant management for 48 hours or to induction of labor 8 hours after premature rupture of membranes. Premature rupture of membranes was confirmed by sterile speculum examination of the vagina. Patients randomized to expectant management were transferred to antenatal care and were not examined vaginally until they went into labor. Patients randomized to induction of labor had induction with oxytocin 8 hours after premature rupture of membranes.
Two hundred sixty-two patients were randomized to the expectant management and induction of labor groups. The cesarean birth rate and the clinical diagnosis of postpartum endometritis was not significantly different in the two groups. Pathologic diagnosis of chorioamnionitis and funisitis, however, was significantly greater in the expectant management group (p < 0.05). Eight of the 15 babies with funisitis were admitted to the neonatal intensive care unit for therapy (two in the induction of labor group and six in the expectant management group, p < 0.05).
Expectant management did not reduce the incidence of cesarean birth and increased the pathologic diagnosis of funisitis and newborn requirements for neonatal intensive care.
Définir le délai de déclenchement optimal dans les ruptures prématurées des membranes (RPM) à terme sur col défavorable permettant de réduire le risque de césarienne et le risque d’infection ...materno-fœtale.
Étude rétrospective réalisée dans deux maternités sur quatre ans comparant trois cohortes homogènes. Toutes les patientes ayant présenté une RPM à terme sur col défavorable (Bishop<6) sur la période donnée ont été incluses. Trois délais d’expectative ont été définis après la rupture : inférieur à sept heures (groupe 1), entre sept et 12heures (groupe 2) et supérieur à 12heures (groupe 3). Les conséquences obstétricales, maternelles et fœtales ont été étudiées dans les trois groupes.
Les groupes 1, 2 et 3 comprenaient respectivement 60, 49 et 46 patientes. Concernant le taux de césarienne, aucune différence significative n’a été observée entre les trois groupes mais il demeurait plus bas dans le groupe 2 : 6,1 % versus 18,3 % dans le groupe 1 et 21,7 % dans le groupe 3. Les morbidités maternelle et fœtale étaient identiques dans les trois groupes.
En cas de RPM à terme sur col défavorable, ni notre étude ni les données de la littérature ne permettent de définir un délai de déclenchement optimal.
To define the optimal delay before inducing labor in the management of premature rupture of the membranes (PRM) at term with unfavourable cervix in order to reduce the risk of caesarean section as well as the risk of maternal and foetal infection.
Retrospective study of three homogeneous groups carried out over on a period of 4years in two centres. All the patients were included after premature rupture of membranes at term with unfavourable cervix (Bishop score<6). We defined three expected delays after PRM at term: less than 7h (group 1), between 7 and 12h (group 2) and more than 12h (group 3). We have assessed the obstetrical, maternal and foetal consequences for each group.
Sixty patients were allocated in group 1, 49 in group 2 and 46 in group 3. There was no significant difference in the rate of caesarean between the three groups but it was lower in group 2: 6.1% versus 18.3% in group 1 and 21.7% in group 3. No statistical difference was observed concerning maternal or foetal infections.
In PRM at term, neither our study nor literature data allow us to conclude about the optimal delay before inducing labor.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Load filters
No result was selected!
Please select the results that you wish to export.
The search was successfully saved.
Editing
The search could not be saved.
Saved searches can be viewed in the list My searches.
The changes made to the saved search were saved successfully.
Save search
Shelf entry
No result was selected!
Adding material to shelf was successful.
Adding material to shelf was partly successful.
Adding material to shelf failed completely.
It was not necessary to add the material to the shelf.
Please select the results that you want to put on shelf!
On shelf the following records have been successfully added:
On shelf the following records have been successfully added:
