Use of Antenatal Corticosteroids in Preterm Prelabor Rupture of Membranes
“Antenatal corticosteroids are important interventions to prevent neonatal morbidity and mortality associated with preterm birth. Administering intramuscular betamethasone or dexamethasone before preterm birth reduces risks of respiratory distress syndrome, intraventricular hemorrhage, necrotizing enterocolitis, and death. These same benefits are seen among women with preterm prelabor rupture of membranes (PPROM) without any proven increased risk of neonatal or maternal infection. Although future studies are needed to elucidate effects of antenatal corticosteroids at less than 23 weeks’ g estation and a rescue course ...
Source: Obstetrics and Gynecology Clinics - October 6, 2020 Category: OBGYN Authors: Ashley N. Battarbee Source Type: research
Antibiotics for Prophylaxis in the Setting of Preterm Prelabor Rupture of Membranes
“For many years, providers have been using antibiotics to prevent infection in women who present with preterm prelabor rupture of membranes (PPROM). Given the polymicrobial nature of intra-amniotic infection, the recommended regimen includes a 7-day course of ampicillin and erythromycin, although many substitute of azithromycin. This regimen is used from viability to 34 weeks, independent of the number of fetuses present. Meta-analyses have shown that antibiotics for this indication are associated with lower rates of maternal and fetal infection, as well as longer pregnancy latency. Thus, l atency antibiotics are recomm...
Source: Obstetrics and Gynecology Clinics - October 6, 2020 Category: OBGYN Authors: Sarah Dotters-Katz Source Type: research
Periviable PROM
This article discusses standard and experimental interventions that may offer neonatal benefit. Antenatal corticosteroids, antibiotics, and magnesium sul fate may improve outcomes but data to support an improvement in outcome are limited. Studies specifically evaluating these interventions are needed. (Source: Obstetrics and Gynecology Clinics)
Source: Obstetrics and Gynecology Clinics - October 6, 2020 Category: OBGYN Authors: Kelly S. Gibson, Kerri Brackney Source Type: research
Neonatal and Childhood Outcomes Following Preterm Premature Rupture of Membranes
Preterm premature rupture of membranes (PPROM) is almost uniformly associated with preterm birth and thus sequelae of prematurity explain many of the complications associated with this condition. However, the unique inflammatory environment and oligohydramnios associated with PPROM may impart unique neonatal and childhood morbidity compared with other preterm birth pathways. (Source: Obstetrics and Gynecology Clinics)
Source: Obstetrics and Gynecology Clinics - October 6, 2020 Category: OBGYN Authors: Lillian B. Boettcher, Erin A.S. Clark Source Type: research
Stillbirth
A systematic, effective stillbirth evaluation is important for identification of potential causes of fetal death. Knowledge of potential causes of fetal death facilitates emotional closure for patients and informs recurrence risk as well as future pregnancy management. The highest-yield components of a stillbirth evaluation for finding a cause of fetal death are fetal autopsy, placental pathology, and genetic testing. All patients should be offered these tests following a stillbirth. A clear plan for postpartum follow-up should be made with the patient in order to ensure ongoing support through the grief and recovery proce...
Source: Obstetrics and Gynecology Clinics - August 4, 2020 Category: OBGYN Authors: Jessica M. Page, Robert M. Silver Source Type: research
