Induction of labor compared with expectant management for prelabor rupture of the membrane at term

Article Abstract:

Expectant management of women with prelabor rupture of the membranes at term results in similar rates of neonatal infection and cesarean section as the immediate inducement of labor for women in the same condition. Prelabor rupture increases the risk of neonatal infection, and the risk is believed to increase as the period between the rupture and labor increases. Expectant management involves monitoring the status of the pregnant woman while waiting for labor to begin spontaneously. Of 5,401 pregnant women with prelabor rupture, 2,517 had labor induced with either intravenous oxytocin or vaginal prostaglandin E2 gel, while 2,524 underwent expectant monitoring, and received one of the two labor-inducing drugs if some increased risk of danger to the mother or child was identified. Rates of neonatal infection ranged from 2% to 3% amongst all of the groups, and cesarian section rates ranged from 9.6% to 10.9%. Women who underwent induced labor seemed to have more positive feelings about the experience than those who underwent expectant monitoring.

Health aspects, Care and treatment, Pregnant women, Labor, Induced (Obstetrics), Induced labor

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Prednisone and aspirin in women with autoantibodies and unexplained recurrent fetal loss

Article Abstract:

Prednisone and aspirin do not appear to be beneficial in women with autoantibodies and recurrent miscarriages. This treatment has been used on the assumption that these women have an autoimmune disorder. Researchers randomly assigned 195 pregnant women who tested positive for autoantibodies to receive prednisone and aspirin or a placebo. Sixty-six women gave birth to live infants in the treatment group versus 57 women in the placebo group. However, 62% of the infants in the treatment group were born prematurely compared to 12% in the placebo group. About three times as many women in the treatment group developed side effects compared to the placebo group.

Evaluation, Prevention, Drug therapy, Autoimmune diseases, Aspirin, Miscarriage, Prednisone

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International Multicentre Term Prelabor Rupture of Membranes Study: evaluation of predictors of clinical chorioamnionitis and postpartum fever in patients with prelabor rupture of membranes at term

Article Abstract:

The number of vaginal examinations performed before delivery in women with prelabor rupture of the membranes may be the highest risk factor for clinical chorioamnionitis. Chorioamnionitis is an infection of the amniotic fluid. Of 5,028 patients with prelabor rupture of the membranes at term, 335 developed clinical chorioamnionitis. Increasing frequency of vaginal examinations was most significantly associated with the development of chorioamnionitis, and was a more important risk factor than the time transpired between the rupture of membranes and delivery.

Complications and side effects, Risk factors, Medical examination, Vagina, Chorioamnionitis

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