Gram stain results from amniocentesis in patients with preterm premature rupture of membranes - comparison of maternal and fetal characteristics

Article Abstract:

When the amniotic sac ('bag of waters'), which surrounds the fetus, ruptures too early in gestation, it is called premature rupture of membranes, or PROM. Complications and fetal mortality as a result of infection are often the consequences. In such cases, identification of infected fetuses at the time of rupture becomes critical. This can be approached by analyzing samples of amniotic fluid collected from the amniotic sac by amniocentesis (withdrawal of the fluid using a syringe). To learn more about the predictive value of results from bacterial analysis of amniotic fluid, medical records from 108 PROM patients (between 24 and 36 weeks' gestation) were reviewed. Of interest was the determination of whether the fluid had stained positive with the Gram stain, a histopathological stain that shows the presence of certain bacteria. Results showed that 77 patients had negative Gram stains and were managed expectantly, with daily nonstress tests (a test of fetal heart rate response) of their fetuses. The remaining 31 patients, who had positive Gram stains and cultures, were delivered of their infants and given antibiotics. Several differences in both maternal and fetal characteristics were found when Gram-positive and Gram-negative deliveries were compared. Infants whose amniotic fluid had tested positive for bacteria were born earlier in gestation, had higher fetal heart rates (FHRs), and reacted less in the nonstress test. The results support the impression that fetuses in an infected amniotic environment do less well than those in a noninfected environment, and imply that amniocentesis, although difficult to perform in patients with PROM, is warranted in cases where the fetal heart rate is accelerated and nonreactive FHR tracings are obtained. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Infection, Complications and side effects, Premature rupture of membranes, Premature rupture of the membrane, Amniocentesis, Amniotic fluid

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Reliability of ultrasonographic formulary in the prediction of fetal weight and survival of very-low-birthweight infants

Article Abstract:

Infants that weigh less than 1,500 grams at birth constitute a small proportion of births (approximately 4 percent), but they account for three quarters of all mortality in the weeks before and after delivery. Birth weight is a strong predictor of perinatal mortality, but it is difficult to estimate before actual birth. To develop a formula for relating results from ultrasound examination to actual infant birth weight, women with threatened premature labor were studied. The weights of 67 fetuses that were between 22 and 28 gestational weeks of age were estimated according to two standard formulas, using the abdominal circumference as the basic measurement. These results were then compared with the actual birth weights. Results showed that the two formulas were equivalent in their accuracy of predicting birth weights. The weight estimates correlated well with the actual weights. Half the infants survived whose gestational age was longer than 25 weeks or who weighed more than 750 grams; infants who were both older than 25 gestational weeks and weighed more than 750 grams had 85 percent survival. The results may be useful in planning obstetrical intervention for very-low-birthweight infants, and may help in deciding whether to transfer an infant to a regional perinatal center or to perform an immediate cesarean delivery. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Measurement, Fetus, Physiological aspects, Birth weight, Low, Low birth weight, Birth weight, Prenatal ultrasonography, Ultrasonics in obstetrics

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Droperidol and diphenhydramine in the management of hyperemesis gravidarum

Article Abstract:

Pregnant women with severe vomiting and dehydration may be successfully treated with infusions of droperidol and diphenhydramine. Researchers offered droperidol and diphenhydramine treatments to 80 pregnant women hospitalized with severe vomiting and dehydration. Compared to a similar group of women hospitalized before this treatment was available, women treated with droperidol and diphenhydramine were in the hospital fewer days and were less likely to be readmitted because of vomiting. Both groups had a similar rate of birth defects, which were not related to vomiting treatments. Drug treatments did not cause fetal or maternal complications.

Evaluation, Drug therapy, Dopamine, Dopamine agonists, Hyperemesis gravidarum, Diphenhydramine

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