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Author: admin, 18.07.2014PPROM diagnostic approaches Conclusions “ Nitrazine and Ferning tests indicated that these tests have high inaccuracy rates, which increase progressively when more than one hour has elapsed since the rupture of the membranes, and become unreliable after 24 hours.
PPROM diagnostic problems Search for new diagnostic methods Developed test systems had high rates of false results Since 1970s, multiple proteins of amniotic fluid have been discovered like Placental Alpha Microglobulin-1 PAMG-1, Alpha Feta Protein (AFP), Fetal Fibronectin (fFn), etc.
In one study (Veleminsky & Tosner, 2008), researchers found that more women who experienced term PROM had a yeast infection than women who did not have term PROM. Rates of maternal infection (chorioamnionitis) were similar between the two groups, for both GBS-negative and GBS-positive women.
There is a theory that Vitamin C can strengthen the membranes and prevent them from breaking early. Most commonly, the pressure of contractions causes the membranes to finally give way at the weak spot, but occasionally this can happen before contractions begin(Moore et al., 2006). Between the years of 1992-1995, a group of researchers from 72 hospitals enrolled 5,041 low-risk women from six different countries (Canada, United Kingdom, Australia, Israel, Sweden, and Denmark) into the TermPROM study.
The chorioamnion (or membrane) is a physical barrier to bacterial invasion during pregnancy, so when the water or membranes break, this means the mother is at higher risk for infection. When we looked at other studies that examined infection (See Annotated Bibliography), most researchers found that induction is associated with a lower risk of infection in the mother.
However it is very important to note that most of these studies do not take into account the number of vaginal exams, or they do not follow current GBS infection protocols (including the TermPROM study, which has been very influential on practice in the US). The reason vaginal exams can lead to infection is because even though care providers use sterile gloves, their fingers are pushing bacteria from the outside of the vagina up to the cervix as they conduct the exam. The TermPROM researchers carefully defined what an infection would be and even had separate doctors evaluate for newborn infection.
Similarly, most other studies have found no difference in rates of infection or most other newborn outcomes (see Annotated Bibliography). Of the ten studies that compared rates of newborn infection between induction and expectant management groups, nine found no difference and one found a higher rate of infection among those infants whose mothers had expectant management. When they only looked at babies born more than 24 hours after PROM, the rate of infection increased slightly to 2.8%. Mothers who developed chorio or had more than 8 vaginal exams during labor had an increased risk of having a newborn with an infection. The current evidence that we have suggests that mothers who experience term PROM should be counseled as to the potential benefits and harms of both induction and expectant management, so that they can make the choice that is most suitable for their unique situation.
If you purchase the PDF package, you will also get four colorful flyers about PROM that you can print and share with anyone you like! One study found that as many as 50% of babies were stillborn or died after birth if their mothers developed a fever or had other signs of infection with PROM (Lanier et al., 1965). This means that many women who were at risk for infections or had early symptoms of infection were not treated until their infections were quite severe.
So the results from these studies probably overestimate the risk of infection that a mother or newborn might experience if she had term PROM today.
All women had a non-stress test before entering the study, and they were not included in the study if they had meconium staining of the amniotic fluid or any signs of infection when they arrived at the hospital.
It was not clear if this was because care providers were being more cautious with these infants. She will complete her doctoral degree in May, and looks forward to applying the writing, public speaking, and research skills honed in her graduate training, as well as her considerable knowledge of many aspects of birth and breastfeeding, to improving the outcomes and experiences of parents and infants in the childbearing year.
Jessika was GBS negative, and she and her baby never showed any signs of infection during labor. These differences can lead to very different findings among studies that are supposed to be answering the same question. Carrying this type of bacteria puts women at higher risk for chorioamnionitis (infection of the membranes) and puts newborns at higher risk for Group B Strep infection. This means that women in the waiting groups were more likely to develop an infection purely based on this first vaginal exam (Seaward et al., 1997). Relationship of vaginal microflora to PROM, pPROM and the risk of early-onset neonatal sepsis.
The chance of infection was 5 times greater in this group of women compared to the private patients. Her GBS status was unknown, she had no vaginal exams prenatally or during labor, and no signs of infection.
International multicenter term PROM study: evaluation of predictors of neonatal infection in infants born to patients with premature rupture of membranes at term.
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