Abstract:
BACKGROUND:Preterm premature rupture of membranes complicates 2-3% of pregnancies. Many institutions have advocated for the use of azithromycin instead of erythromycin. This is secondary to national shortages of erythromycin, ease of administration, better side effect profile, and decreased cost of azithromycin as compared with erythromycin. OBJECTIVE:The objective of the study was to evaluate whether there are differences in the latency from preterm premature rupture of membranes to delivery in patients treated with different dosing regimens of azithromycin vs erythromycin. STUDY DESIGN:This is a multicenter, retrospective cohort of women with singleton pregnancies with confirmed rupture of membranes between 230 and 336 weeks from January 2010 to June 2015. Patients were excluded if there was a contraindication to expectant management of preterm premature rupture of membranes. Patients received 1 of 4 antibiotic regimens: (1) azithromycin 1000 mg per os once (azithromycin 1 day group); (2) azithromycin 500 mg per os once, followed by azithromycin 250 mg per os daily for 4 days (azithromycin 5 day group); (3) azithromycin 500 mg intravenously for 2 days, followed by azithromycin 500 mg per os daily for 5 days (azithromycin 7 day group); or (4) erythromycin intravenously for 2 days followed by erythromycin per os for 5 days (erythromycin group). The choice of macrolide was based on institutional policy and/or availability of antibiotics at the time of admission. In addition, all patients received ampicillin intravenously for 2 days followed by amoxicillin per os for 5 days. Primary outcome was latency from diagnosis of rupture of membranes to delivery. Secondary outcomes included clinical and histopathological chorioamnionitis and neonatal outcomes. RESULTS:Four hundred fifty-three patients who met inclusion criteria were identified. Seventy-eight patients received azithromycin for 1 day, 191 patients received azithromycin for 5 days, 52 patients received azithromycin for 7 days, and 132 patients received erythromycin. Women who received the 5 day regimen were younger and less likely to be non-African American, have hypertension, have sexually transmitted infection, or experienced substance abuse. There was no statistical difference in median latency time of azithromycin 1 day (4.9 days, 95% confidence interval, 3.3-6.4), azithromycin 5 days (5.0, 95% confidence interval, 3.9-6.1), or azithromycin 7 days (4.9 days, 95% confidence interval, 2.8-7.0) when compared with erythromycin (5.1 days, 95% confidence interval, 3.9-6.4) after adjusting for demographic variables (P = .99). Clinical chorioamnionitis was not different between groups in the adjusted model. Respiratory distress syndrome was increased in the azithromycin 5 day group vs azithromycin 1 day vs erythromycin (44% vs. 29% and 29%, P = .005, respectively). CONCLUSION:There was no difference in latency to delivery, incidence of chorioamnionitis, or neonatal outcomes when comparing different dosing regimens of the azithromycin with erythromycin, with the exception of respiratory distress syndrome being more common in the 5 day azithromycin group. Azithromycin could be considered as an alternative to erythromycin in the expectant management of preterm premature rupture of membranes if erythromycin is unavailable or contraindicated. There appears to be no additional benefit to an extended course of azithromycin beyond the single-day dosing, but final recommendations on dosing strategies should rely on clinical trials.
journal_name
Am J Obstet Gynecoljournal_title
American journal of obstetrics and gynecologyauthors
Navathe R,Schoen CN,Heidari P,Bachilova S,Ward A,Tepper J,Visintainer P,Hoffman MK,Smith S,Berghella V,Roman Adoi
10.1016/j.ajog.2019.03.009subject
Has Abstractpub_date
2019-08-01 00:00:00pages
144.e1-144.e8issue
2eissn
0002-9378issn
1097-6868pii
S0002-9378(19)30485-5journal_volume
221pub_type
杂志文章,多中心研究abstract:OBJECTIVE:The purpose of this study was to determine the contribution of randomization to nicotine replacement therapy (NRT), sociodemographic and psychosocial factors, and pregnancy and medical history to serious perinatal adverse events among pregnant smokers. STUDY DESIGN:We performed a retrospective review of all ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ajog.2009.06.006
更新日期:2009-10-01 00:00:00
abstract::Twin-twin transfusion syndrome associated with acute polyhydramnios in one sac and severe oligohydramnios in the other, which characteristically is diagnosed between 18 and 28 weeks, is associated with a high mortality rate for the involved twins. Patients who are managed without intervention have essentially 100% per...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(90)90618-h
更新日期:1990-11-01 00:00:00
abstract:OBJECTIVE:The objective of the study was to examine the effect of first-trimester obstetric ultrasound (OBUS) on the measurement of the effect of complications ascribed to postterm pregnancies. STUDY DESIGN:We conducted a retrospective cohort study of all term, singleton pregnancies delivered at our institution who ha...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2008.03.034
更新日期:2008-06-01 00:00:00
abstract:OBJECTIVE:The objective of the study was to study posttherapy chemoradiation hysterectomy histology with long-term survival in bulky stage 1(B) cervical cancer patients. STUDY DESIGN:Gynecologic Oncology Group protocols 71 and 123 enrolled 464 patients randomly allocated to pelvic radiation (75 Gy, n = 291) plus hyste...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ajog.2010.05.005
更新日期:2010-10-01 00:00:00
abstract::Normal and genetic variant strains of nonmalignant human fibroblasts produce in vitro a substance indistinguishable from the recently described "pregnancy-specific" beta-1 glycoprotein (PSbetaG, PAPP-C, SP1). Demonstration of this presumed placenta-specific material in a nonplacental site raises questions about its no...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(79)90938-4
更新日期:1979-08-01 00:00:00
abstract:OBJECTIVES:In utero gene therapy has a potential to correct genetic disorders before the first clinical symptoms appear. Our aim was to examine whether the exocoelomic cavity between amniotic and chorionic membranes offers a minimally invasive route for gene transfer to the fetus during early pregnancy. STUDY DESIGN:W...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2003.07.010
更新日期:2004-01-01 00:00:00
abstract::Sacral neuromodulation with an implanted device is used in patients who experience urinary retention and malfunctioning overactive bladder where conservative treatment is not sufficient. The knowledge of its effect on pregnancy is not known. This article presents the case of a 34-year-old pregnant woman with an implan...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2014.04.015
更新日期:2014-07-01 00:00:00
abstract:OBJECTIVE:The mechanism underlying myometrial quiescence during pregnancy is unknown. Our group has previously shown that during pregnancy myometrial cyclic guanosine monophosphate content rises to several hundred times the nonpregnant levels, only to abruptly decline days before the onset of labor. Cyclic guanosine mo...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2000.107462
更新日期:2000-12-01 00:00:00
abstract::Pelvic inflammatory disease is a major medical problem that causes serious complications in a large number of the female population in many developing countries. It is estimated that between 20% and 30% of gynecologic admissions in these countries are due to PID. The alarmingly high prevalence of gonorrhea is probably...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/0002-9378(80)91114-x
更新日期:1980-12-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to correlate the diagnosis of endometriosis on the basis of visualization at laparoscopy with the pathologic diagnosis. STUDY DESIGN:A prospective study of 44 patients undergoing laparoscopy for the evaluation of chronic pelvic pain was carried out. All areas suggestive of endom...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2001.115747
更新日期:2001-06-01 00:00:00
abstract::Validity refers to an evidence-based claim about the trustworthiness of decisions made from context-specific performance data. Validity requirements for competency-based assessments in obstetrics and gynecology have not been defined in the literature. We explain why validity is intrinsic to any discussion about compet...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2011.01.061
更新日期:2011-05-01 00:00:00
abstract::Ocular malignant melanoma, similar to the cutaneous variety, may metastasize to the placenta, almost always in the presence of widespread disease. The prognosis is poor, and there is a 25% risk of spread to the fetus. All women with a history of this disease should be informed of the risks when they are contemplating ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(96)70626-9
更新日期:1996-05-01 00:00:00
abstract:OBJECTIVE:This study was undertaken to investigate the efficacy of nonoxynol 9 suppositories in the treatment of vaginal trichomoniasis. STUDY DESIGN:In this prospective comparison trial 46 women with documented motile trichomonads found on a wet preparation were randomly assigned to one of two treatment arms: (1) a s...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1067/mob.2000.105388
更新日期:2000-05-01 00:00:00
abstract:OBJECTIVE:This study was conducted to evaluate use of light-induced autofluorescence for measuring changes in collagen of cervical connective tissue during gestation. STUDY DESIGN:In a conventional laboratory setting light-induced autofluorescence from the cervix of Charles-Dawley timed pregnant rats was measured in v...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(95)90648-7
更新日期:1995-11-01 00:00:00
abstract:OBJECTIVE:The purpose of this report is to bring to the attention of obstetric care providers the occurrence in pregnancy of a threatening pulmonary syndrome caused by hantavirus infection. STUDY DESIGN:Two recent cases of hantavirus pneumonitis in pregnancy, one complicated by adult respiratory distress syndrome, are...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(94)90298-4
更新日期:1994-08-01 00:00:00
abstract:OBJECTIVE:We sought to evaluate postsurgical adhesions in women of different races with or without keloids. STUDY DESIGN:This was a prospective study evaluating postsurgical adhesions after a cesarean delivery in 429 women with or without keloids. The outcome measures were the prevalence and extent of adhesions in wom...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2010.09.005
更新日期:2011-02-01 00:00:00
abstract::Postpartum ultrasonographic examination of a patient with a retained placenta showed findings consistent with placenta accreta. The diagnosis was confirmed after surgery with histopathologic examination of the uterus. This case illustrates the possible clinical application of ultrasonography in the postpartum diagnosi...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(11)91557-9
更新日期:1992-09-01 00:00:00
abstract:BACKGROUND:Premenstrual syndrome is characterized by the cyclic occurrence of physical, behavioral and psychological symptoms during the luteal phase of the menstrual cycle disappearing within a few days of the onset of menstruation. Generally symptoms are mild, but 5-8% of women suffer from severe PMS. Apart from conv...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.ajog.2017.02.028
更新日期:2017-08-01 00:00:00
abstract:OBJECTIVE:Our objective was to investigate the possible restoring action of magnesium on vascular sensitivity to angiotensin II in pregnancy. STUDY DESIGN:We studied intraplatelet free calcium and the pressor response to angiotensin II in 10 primigravid women (28 to 32 weeks' gestation) at risk for pregnancy induced h...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(12)80006-8
更新日期:1992-10-01 00:00:00
abstract:OBJECTIVE:Our purpose was to determine whether the combination of maternal serum alpha-fetoprotein, free human chorionic gonadotropin-beta, dimeric inhibin A, and maternal age detects aneuploidies other than Down syndrome. STUDY DESIGN:We retrieved stored serum from pregnancies complicated by aneuploidies other than D...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(98)70198-x
更新日期:1998-10-01 00:00:00
abstract::In 39 pregnant and six nonpregnant dogs the abdominal aorta was exposed extraperitoneally through a left paralumbar incision, and a vascular occluder and a flow transducer were placed around it. The tubing of the occluder and the wiring of the flow transducer were slipped under the skin and advanced to the back of the...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(81)90512-3
更新日期:1981-03-01 00:00:00
abstract:OBJECTIVE:We performed a systematic review and meta-analysis to determine whether D-mannose reduces urinary tract infection recurrence (ie, cumulative incidence) in adult women with recurrent urinary tract infection compared with other prevention agents. Secondary outcomes included side effects and compliance with D-ma...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,meta分析
doi:10.1016/j.ajog.2020.05.048
更新日期:2020-08-01 00:00:00
abstract:OBJECTIVE:The objective of the study was to compare biomechanical properties of vaginal versus abdominal surgical wound healing in the rabbit. STUDY DESIGN:Bilateral 6-mm full-thickness circular segments were excised from the vagina and abdominal skin in 38 New Zealand White female rabbits. Animals were killed 0, 4, 7...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2006.01.063
更新日期:2006-05-01 00:00:00
abstract::The sinusoidal fetal heart rate pattern is a phenomenon of elusive pathophysiologic features and uncertain clinical significance. We present a case of sinusoidal fetal heart rate that occurred in association with fetal breathing. The degree and type of synchrony between the sinusoidal fetal heart rate and breathing mo...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(89)80060-2
更新日期:1989-03-01 00:00:00
abstract::A simple modification of the technique of transabdominal chorionic villus sampling is described. This technique uses a short piece of extension tubing between the needle hub and aspirating syringe. The advantages of this technique are discussed. ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(92)91659-x
更新日期:1992-02-01 00:00:00
abstract:OBJECTIVE:The objective of the study was to further investigate a previous finding that tubal sterilization followed by hysterectomy was associated with hydrosalpinx formation. STUDY DESIGN:The Rochester Epidemiology Project (Rochester, MN) was used to identify three cohorts: women who had undergone tubal sterilizatio...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2005.11.014
更新日期:2006-05-01 00:00:00
abstract::The effects of fasting on maternal glucose metabolism were investigated in nonpregnant and 29-day pregnant conscious rabbits. Pregnancy decreased the glucose metabolic index by 60% in maternal red postural muscles. Fasting induced similar modifications in nonpregnant rabbits and exaggerated the changes observed in fed...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(88)90257-8
更新日期:1988-05-01 00:00:00
abstract::We have examined the ability of activators of adenylate cyclase and cyclic adenosine monophosphate to affect the output of prostaglandins E and F by dispersed cells of amnion and decidua collected from women following spontaneous labor. Cyclic adenosine monophosphate production by amnion and decidua cells was stimulat...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(85)90592-7
更新日期:1985-09-01 00:00:00
abstract:OBJECTIVE:This study was undertaken to report on the benign gynecologic conditions occurring among women with an intact uterus at enrollment in the Breast Cancer Prevention Trial of the National Surgical Adjuvant Breast and Bowel Project. STUDY DESIGN:The incidence rates of several benign gynecologic conditions were d...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:10.1016/j.ajog.2004.12.083
更新日期:2005-04-01 00:00:00
abstract::Matings between mice carrying the heterozygous autosomal gene Steel produce 25% homozygous Sl/Sld mutants having agametic gonads composed of somatic tissue alone. Mutants show a normal 1:1 male:female sex ratio and gonadal sex corresponds to genotypic sex. Gonads from both normal and mutant male and female fetuses wer...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(83)90319-8
更新日期:1983-02-15 00:00:00