Abstract:
:Premature rupture of the membranes (PROM), defined as rupture of the membranes before the onset of labor, is a common obstetric event occurring in 10% of pregnancies. Most of the time this occurs at or beyond 37 weeks' gestation with only 10% of PROM occurring at less than 37 weeks' gestation. The natural course of PROM is labor, and at term this is associated with a low rate of complications for the mother and the fetus. At less than 37 weeks' gestation PROM places the mother and the fetus at increased risk of short-term and long-term morbidity and mortality. Several factors related to preterm premature rupture of the membranes (PROM) add risk to the pregnancy and include premature delivery, infection in the mother and the fetus, effects of prolonged oligohydramnios on fetal development, abruptio placenta, prolapsed cord, and fetal malposition. Since the 1970s expectant management has been the standard treatment for PROM; however, in the majority of patients, this strategy results in the delivery of a preterm infant. In addition, controversy exists over the gestational age at which expectant management should be abandoned and active interventions to effect delivery pursued. This article discusses the natural history of PROM, the outcome of expectant management in PROM, and maternal and fetal outcomes in these patients. The emphasis of this discussion is on the preterm fetus.
journal_name
Semin Perinatoljournal_title
Seminars in perinatologyauthors
Alexander JM,Cox SMdoi
10.1016/s0146-0005(96)80003-6subject
Has Abstractpub_date
1996-10-01 00:00:00pages
369-74issue
5eissn
0146-0005issn
1558-075Xpii
S0146-0005(96)80003-6journal_volume
20pub_type
杂志文章,评审abstract:BACKGROUND:Pulmonary inflammation, increased production of the inflammatory cytokine interleukin-1beta (IL-1beta), and vitamin A deficiency are risk factors for the development of bronchopulmonary dysplasia (BPD) in premature infants. To determine the mechanisms by which IL-1beta influences lung development, we have ge...
journal_title:Seminars in perinatology
pub_type: 杂志文章
doi:10.1053/j.semperi.2006.04.009
更新日期:2006-06-01 00:00:00
abstract::Adverse pregnancy outcome from environmental factors may include congenital anomalies, increased risk for miscarriage, preterm delivery, intrauterine growth restriction, and still birth. Apart from adverse pregnancy outcome, there may be effects on the other reproductive functions, like menstrual disorders and inferti...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2007.07.013
更新日期:2007-08-01 00:00:00
abstract::Diagnostic errors remain understudied in neonatology. The limited available evidence, however, suggests that diagnostic errors in the neonatal intensive care unit (NICU) result in significant and long-term consequences. In this narrative review, we discuss how the concept of diagnostic errors framed as missed opportun...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2019.08.004
更新日期:2019-12-01 00:00:00
abstract::Neonatal hyperinsulinism (HI) is a clinical syndrome of pancreatic beta-cell dysfunction characterized by failure to suppress insulin secretion in the presence of hypoglycemia. Although rare, it is the most common cause for persistent hypoglycemia in the newborn period. Treatment can be extremely difficult, and partia...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/sp.2000.6365
更新日期:2000-04-01 00:00:00
abstract::The developing heart undergoes a remarkable metabolic transformation as it adjusts to the higher-oxygen, extrauterine environment. During gestation, glycolysis and lactate oxidation constitute the major sources of adenosine triphosphate (ATP) for the fetal heart. After birth, however, there is a rapid shift from carbo...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1016/s0146-0005(96)80068-1
更新日期:1996-12-01 00:00:00
abstract::Late preterm infants (34-37 weeks postmenstrual age at birth) are intermediate between less mature preterm infants and infants born at 38 weeks or more in regard to autonomic brain stem maturation. Ventilatory responses to CO(2) in preterm infants born at 33 to 36 week are significantly higher than in infants born at ...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2006.02.005
更新日期:2006-04-01 00:00:00
abstract::The incidence of twin gestation has increased significantly over the past 30 years. One of the most significant public health implications of this trend is the increased incidence of preterm birth (PTB). Efforts to improve neonatal outcomes must address the rate of PTB, particularly among multiple gestations, which co...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2012.02.003
更新日期:2012-06-01 00:00:00
abstract::Asthma may be the most common potentialy serious medical problem to complicate pregnancy. Because severe uncontrolled asthma may cause both maternal and fetal morbidity and mortality, pharmacological asthma therapy is often necessary during pregnancy. Only 1 published randomized controlled clinical trial has evaluated...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/sper.2001.24569
更新日期:2001-06-01 00:00:00
abstract::The outcome literature on low birthweight (LBW) premature children indicates that they are at risk for a variety of neurodevelopmental impairments throughout childhood. To prevent such disabilities, numerous interventions have been initiated with LBW children. Nineteen intervention programs designed for LBW preterms t...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1016/s0146-0005(05)80049-7
更新日期:1995-08-01 00:00:00
abstract::Ethics is an essential dimension of the management of periviable birth in both clinical practice and research. The goal of clinical care in periviable birth is to improve outcomes for current pregnant and fetal patients. The goal of research in periviable birth is to improve outcomes for future pregnant patients and f...
journal_title:Seminars in perinatology
pub_type: 杂志文章
doi:10.1053/j.semperi.2013.06.027
更新日期:2013-12-01 00:00:00
abstract::Sudden unexpected changes in the life of a family create many different emotions in various family members. The death of a young woman during or after her pregnancy is especially difficult because of the strain it places on family dynamics. One of the consequences is that there is, commonly, a newborn, and perhaps oth...
journal_title:Seminars in perinatology
pub_type: 杂志文章
doi:10.1053/j.semperi.2011.09.014
更新日期:2012-02-01 00:00:00
abstract::Preeclampsia, intrauterine growth restriction (IUGR), and placental abruption are obstetrical conditions that constitute the syndrome of ischemic placental disease or IPD, the leading cause of indicated preterm birth and an important cause of neonatal morbidity and mortality. While the phenotypic manifestations vary s...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2014.03.002
更新日期:2014-04-01 00:00:00
abstract::Neonatal erythropoiesis is limited by a relatively inadequate production of erythropoietin. This is likely the result of dependence on the hepatic production of erythropoietin and an incomplete switchover to renal production. The present model of neonatal erythropoiesis suggests that the use of exogenous erythropoieti...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1016/s0146-0005(97)80016-x
更新日期:1997-02-01 00:00:00
abstract::Oligohydramnios is a severe and common complication of pregnancy. The finding of oligohydramnios can be associated with fetal anomalies, PROM, uteroplacental insufficiency (eg, growth retardation, postdatism, abruptio placenta, significant maternal illness), abnormalities of twinning, and idiopathic oligohydramnios. U...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:
更新日期:1993-06-01 00:00:00
abstract::Although a minor constituent by weight, surfactant protein B (SP-B) plays a major role in surfactant function. It is the unique structure of SP-B that promotes permeabilization, cross-linking, mixing, and fusion of phospholipids, facilitating the proper structure and function of pulmonary surfactant as well as contrib...
journal_title:Seminars in perinatology
pub_type: 杂志文章
doi:10.1053/j.semperi.2008.08.003
更新日期:2008-10-01 00:00:00
abstract::There is increasing evidence that cardiac dysfunction is a key contributor to CDH pathophysiology. Dysfunction in both right and left ventricles is common in the early neonatal period, contributes to clinical disease severity, and is associated with adverse outcomes including death and ECMO use. Early and routine asse...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2019.07.007
更新日期:2020-02-01 00:00:00
abstract::Down syndrome (DS) screening has been an integral part of routine prenatal screening for the last three decades. Recent efforts have been directed at developing additional non-invasive prenatal screening techniques that could not only improve sensitivity of prenatal screening, but also be employed in the first trimest...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2005.05.003
更新日期:2005-08-01 00:00:00
abstract::Seizures during pregnancy complicate <1% of all gestations; however, they are associated with increased adverse maternal and perinatal outcomes (acute and long term). The differential diagnosis of seizures in pregnancy is extensive. Determining the underlying etiology is crucial in the management of these patients. Me...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2013.04.001
更新日期:2013-08-01 00:00:00
abstract::Use of immunosuppressants during pregnancy is indicated for anti-rejection therapy in transplantation patients and treatment of autoimmune diseases. Maternal side effects include nephrotoxocity and hepatotoxicity. All immunosuppressant drugs cross the placenta. Immunosuppressant use during the first trimester is not s...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1016/s0146-0005(97)80057-2
更新日期:1997-04-01 00:00:00
abstract::The safety of cesarean section has improved dramatically over the past 50 years. During the past 20 years a greater awareness of and discussion about the symptomatic morbidity that can result for women following vaginal delivery has occurred and women's expectations for the outcome of pregnancy for them and their babi...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/sper.2003.50002
更新日期:2003-02-01 00:00:00
abstract::Cirrhosis and portal hypertension infrequently coincide with pregnancy but increase maternal and fetal morbidity and mortality when present. Chronic liver disease and portal hypertension are not contraindications to pregnancy but necessitate intensive monitoring throughout pregnancy. The complications of liver disease...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1016/s0146-0005(98)80048-7
更新日期:1998-04-01 00:00:00
abstract::For many years, all of the described cases of monoamine neurotransmitter deficiency were associated with hyperphenylalaninemia that was generally detected at neonatal screening. It is now clear that inherited deficiency of monoamines often occurs in the absence of hyperphenylalaninemia and that the normal battery of s...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1016/s0146-0005(99)80051-2
更新日期:1999-04-01 00:00:00
abstract::Neuroblastoma is the most common malignant neoplasm occurring in the neonate and arguably the most variable in its presentation. This review examines differences in the tumor's clinical course in the context of known biologic determinants of behavior. Tumors that would go undetected except for prenatal ultrasonography...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1016/s0146-0005(99)80035-4
更新日期:1999-08-01 00:00:00
abstract::Pulmonary aspiration of gastric contents is a leading cause of maternal morbidity and mortality for patients during labor. The risk is increased in those women who require obstetric surgery and general anesthesia. Furthermore, gastric aspiration is believed to be largely preventable. Care providers can reduce the risk...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1016/s0146-0005(97)80074-2
更新日期:1997-08-01 00:00:00
abstract::The principal objective of antenatal testing is to detect fetal hypoxia before the fetus has suffered lasting harm. This article summarizes some of the mechanisms by which fetal oxygen consumption is maintained under normal conditions, and adaptations that occur in response to hypoxemia. Alterations in the fetal heart...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2008.04.003
更新日期:2008-08-01 00:00:00
abstract::The incidence of twins, triplets, and high-order multiples has increased dramatically in the last two decades secondary to greater reliance on fertility treatments and to delayed childbearing. Offspring of a multiple gestation are at increased risk for both chromosomal and structural abnormalities. Prenatal diagnosis ...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2005.08.005
更新日期:2005-10-01 00:00:00
abstract::Intrauterine growth restriction (IUGR), which complicates approximately 3% to 10% of all pregnancies leads to preferential hemodynamic changes in affected fetuses. Advanced ultrasound modalities allow reliable and reproducible assessment of the intrauterine fetal cardiac function. Among other methods, combined cardiac...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2008.02.010
更新日期:2008-06-01 00:00:00
abstract::Medium- and long-term outcomes have been collected and described among survivors of neonatal intensive care units for decades, for a number of purposes: (1) quality control within units, (2) comparisons of outcomes between NICUs, (3) clinical trials (whether an intervention improves outcomes), (4) end-of-life decision...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2016.09.009
更新日期:2016-12-01 00:00:00
abstract::The future health of infants and children is dependent on the performance of clinical research in which infants participate. Achieving a proper balance between this social good and the obligation to protect infants who participate in research is a significant challenge. As investigators design and implement research p...
journal_title:Seminars in perinatology
pub_type: 杂志文章
doi:10.1053/j.semperi.2009.07.003
更新日期:2009-12-01 00:00:00
abstract::The importance of omega-3 long chain polyunsaturated fatty acids in the perinatal period has been the focus of research for several decades. Infants born preterm miss out on the last trimester in utero transfer of omega-3 fatty acids and consequently have lower blood levels than infants born at term. Preterm infant fo...
journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
doi:10.1053/j.semperi.2019.06.004
更新日期:2019-11-01 00:00:00