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Sample records for prelabor premature rupture

  1. The preterm cervix reveals a transcriptomic signature in the presence of premature prelabor rupture of membranes.

    Science.gov (United States)

    Makieva, Sofia; Dubicke, Aurelija; Rinaldi, Sara F; Fransson, Emma; Ekman-Ordeberg, Gunvor; Norman, Jane E

    2017-06-01

    Premature prelabor rupture of fetal membranes accounts for 30% of all premature births and is associated with detrimental long-term infant outcomes. Premature cervical remodeling, facilitated by matrix metalloproteinases, may trigger rupture at the zone of the fetal membranes overlying the cervix. The similarities and differences underlying cervical remodeling in premature prelabor rupture of fetal membranes and spontaneous preterm labor with intact membranes are unexplored. We aimed to perform the first transcriptomic assessment of the preterm human cervix to identify differences between premature prelabor rupture of fetal membranes and preterm labor with intact membranes and to compare the enzymatic activities of matrix metalloproteinases-2 and -9 between premature prelabor rupture of fetal membranes and preterm labor with intact membranes. Cervical biopsies were collected following preterm labor with intact membranes (n = 6) and premature prelabor rupture of fetal membranes (n = 5). Biopsies were also collected from reference groups at term labor (n = 12) or term not labor (n = 5). The Illumina HT-12 version 4.0 BeadChips microarray was utilized, and a novel network graph approach determined the specificity of changes between premature prelabor rupture of fetal membranes and preterm labor with intact membranes. Quantitative reverse transcription-polymerase chain reaction and Western blotting confirmed the microarray findings. Immunofluorescence was used for localization studies and gelatin zymography to assess matrix metalloproteinase activity. PML-RARA-regulated adapter molecule 1, FYVE-RhoGEF and PH domain-containing protein 3 and carcinoembryonic antigen-ralated cell adhesion molecule 3 were significantly higher, whereas N-myc downstream regulated gene 2 was lower in the premature prelabor rupture of fetal membranes cervix when compared with the cervix in preterm labor with intact membranes, term labor, and term not labor. PRAM1 and CEACAM3 were localized

  2. Histological evidence of oxidative stress and premature senescence in preterm premature rupture of the human fetal membranes recapitulated in vitro

    National Research Council Canada - National Science Library

    Menon, Ramkumar; Boldogh, Istvan; Hawkins, Hal K; Woodson, Michael; Polettini, Jossimara; Syed, Tariq Ali; Fortunato, Stephen J; Saade, George R; Papaconstantinou, John; Taylor, Robert N

    2014-01-01

    Preterm prelabor rupture of the membranes (pPROM) may lead to preterm births (PTBs). We investigated premature senescence of fetal membranes in women with pPROM and spontaneous PTB with intact membranes...

  3. Intraamniotic Inflammation in Women with Preterm Prelabor Rupture of Membranes.

    Directory of Open Access Journals (Sweden)

    Ivana Musilova

    Full Text Available To characterize subgroups of preterm prelabor rupture of membranes (PPROM and short-term neonatal outcomes based on the presence and absence of intraamniotic inflammation (IAI and/or microbial invasion of the amniotic cavity (MIAC.One hundred and sixty-six Caucasian women with singleton pregnancies were included in this study. Amniotic fluid samples were obtained by transabdominal amniocentesis (n=166 and were assayed for interleukin-6 levels by a lateral flow immunoassay. The presence of Ureaplasma species, Mycoplasma hominis, Chlamydia trachomatis, and 16S rRNA was evaluated in the amniotic fluid. IAI was defined as amniotic fluid IL-6 values, measured by a point of care test, higher than 745 pg/mL.Microbial-associated IAI (IAI with MIAC and sterile intraamniotic inflammation (IAI alone were found in 21% and 4%, respectively, of women with PPROM. Women with microbial-associated IAI had higher microbial loads of Ureaplasma species in the amniotic fluid than women with MIAC alone. No differences in the short-term neonatal morbidity with respect to the presence of microbial-associated IAI, sterile IAI and MIAC alone were found after adjusting for the gestational age at delivery in women with PPROM.Microbial-associated but not sterile intraamniotic inflammation is common in Caucasian women with PPROM. The gestational age at delivery but not the presence of inflammation affects the short-term neonatal morbidity of newborns from PPROM pregnancies.

  4. Management of prelabor rupture of membranes at term. A randomized study

    DEFF Research Database (Denmark)

    Sperling, Lene; Schantz, A L; Wåhlin, A

    1993-01-01

    OBJECTIVE: To compare the rate of obstetric interventions, length of labor, and maternal morbidity in pregnancies with prelabor rupture of membranes at term after either early or late induction of labor in both primiparous and pluriparous women. DESIGN: Prospective, randomized study. SUBJECTS: 362...

  5. Amniotic fluid cathepsin-G in pregnancies complicated by the preterm prelabor rupture of membranes.

    Science.gov (United States)

    Musilova, Ivana; Andrys, Ctirad; Drahosova, Marcela; Soucek, Ondrej; Pliskova, Lenka; Stepan, Martin; Bestvina, Tomas; Maly, Jan; Jacobsson, Bo; Kacerovsky, Marian

    2017-09-01

    The aim of this study was to evaluate the amniotic fluid cathepsin-G concentrations in women with preterm prelabor rupture of membranes (PPROM) based on the presence of the microbial invasion of the amniotic cavity (MIAC) and/or intra-amniotic inflammation (IAI). A total of 154 women with singleton pregnancies complicated by PPROM were included in this study. Amniotic fluid samples were obtained by transabdominal amniocentesis. Amniotic fluid cathepsin-G concentrations were assessed by ELISA. MIAC was determined using a non-cultivation approach. IAI was defined as an amniotic fluid bedside interleukin-6 concentration ≥ 745 pg/mL. Women with MIAC had higher amniotic fluid cathepsin-G concentrations than women without MIAC (with MIAC: median 82.7 ng/mL, versus without MIAC: median 64.7 ng/mL; p = 0.0003). Women with IAI had higher amniotic fluid cathepsin-G concentrations than women without this complication (with IAI: median 103.0 ng/mL, versus without IAI: median 66.2 ng/mL; p G concentrations than women with colonization (MIAC without IAI) and women without both MIAC and IAI (p G concentrations in pregnancies complicated by PPROM. Amniotic fluid cathepsin-G appears to be a potential marker of IAI.

  6. Orally administered misoprostol for induction of labor with prelabor rupture of membranes at term.

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    Radoff, Kari A

    2014-01-01

    Prelabor rupture of membranes (PROM) occurs in approximately 8% to 10% of women with term pregnancies. The management of PROM continues to be controversial. Approaches include expectant management and immediate induction of labor. The use of orally administered misoprostol for the management of women with PROM may provide significant advantages when they choose immediate induction of labor. This literature review presents current evidence that supports the use of oral misoprostol for women with PROM, including the benefits of a decreased interval time from PROM to vaginal birth, good safety profile, and reductions in the use of oxytocin augmentation and epidural anesthesia. In addition to clinically proven benefits to women of oral misoprostol for PROM, it also has the potential to reduce chorioamnionitis by reducing the number of sterile vaginal examinations performed thereby reducing the risk of ascending bacteria. Women have also reported acceptability and satisfaction when using oral misoprostol for immediate induction of labor. This review of literature discusses what is known about the use of orally administered misoprostol for the management of term PROM and makes recommendations for clinical use.

  7. [Premature rupture of membranes and chorioamnionitis].

    Science.gov (United States)

    Lopez Garcia, R

    1988-01-01

    Despite advances in perinatal medicine in the past decade, the diagnosis and treatment of premature rupture of membranes remain controversial. Premature rupture occurs in 2.7-7.0% of pregnancies and most cases occur spontaneously without apparent cause. The disparity in reported rates of premature rupture is due to differences in the definition and diagnostic criteria for premature rupture and lack of comparability in the populations studied. Mexico's National Institute of Perinatology has adopted the definition of the American COllege of Gynecology and Obstetrics which views premature rupture as that occurring before regular uterine contractions that produce cervical dilation. 8.8% of its patients have premature rupture according to this definition. 20% of cases occur before the 36th week of pregnancy. Treatment of rupture occurring before 37 weeks must balance the threat of amniotic infection with the dangers of premature birth. Infections appear more common in low income patient populations. Chorioamnionitis is a serious complication of pregnancy and is the main argument against conservative treatment of premature rupture. The rate of maternal infection is directly related to the time elapsing between rupture of the membranes and birth. The rate increases after the 1st 24 hours and is at least 10 times higher after 72 hours. But recent studies suggest that there is no considerable increase in infection if vaginal explorations are avoided and careful techniques are used in treating the patient. Those who advise conservative treatment believe that prenatal outcomes are better because respiratory disease syndrome due to prematurity is avoided. Conservative management requires a white cell count at least every 24 hours and measurement of pulse, maternal temperature, and fetal heart rate ideally every 4 hours. Perinatal mortality rates due to premature rupture of membranes range from 2.5-50%. The principal causes are respiratory disease syndrome, infection, asphyxia

  8. Preterm premature rupture of membranes: is home care acceptable?

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    Dussaux, Chloé; Senat, Marie-Victoire; Bouchghoul, Hanane; Benachi, Alexandra; Mandelbrot, Laurent; Kayem, Gilles

    2017-07-06

    Preterm prelabor rupture of membranes is a frequent obstetric condition associated with increased risks of maternal and neonatal morbidity and mortality. Conventional management is in hospital. Outpatient management is an alternative in selected cases; however, the safety of home management has not been established. To study the obstetric and neonatal outcomes of women with preterm premature rupture of membranes between 24 and 34 weeks who were managed as outpatient (outpatient care group), compared with those managed in hospital (hospital care group). A retrospective cohort study between 1 January 2009 and 31 December 2013 in three French tertiary care centers. Ninety women were included in the outpatient care group and 324 in the hospital care group. In the outpatient care group, the gestational age at membrane rupture was lower, compared to the hospital care group (28.8 (26.6-30.5) vs. 30.3 (27.6-32.1) weeks; p < .01) and the cervical length at admission was higher (31.7 ± 10.4 vs. 24.3 ± 11.8 mm; p < .01). In the outpatient care group, no delivery or major obstetric complication occurred at home. We observed no major complication related to home care after a period of observation. A randomized study would be necessary to confirm its safety.

  9. Periodontal disease and intra-amniotic complications in women with preterm prelabor rupture of membranes.

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    Radochova, Vladimira; Kacerovska Musilova, Ivana; Stepan, Martin; Vescicik, Peter; Slezak, Radovan; Jacobsson, Bo; Kacerovsky, Marian

    2017-08-04

    Periodontal disease is frequently suggested as a possible causal factor for preterm delivery. The link between periodontal disease and preterm delivery is a possible translocation of periopathogenic bacteria to the placenta and amniotic fluid as well as a systemic response to this chronic inflammatory disease. However, there is a lack of information on whether there is an association between clinical periodontal status in women with preterm prelabor rupture of membranes (PPROM) and the presence of microbial invasion of the amniotic cavity (MIAC) and intra-amniotic inflammation (IAI). Therefore, the main aim of this study was to evaluate the incidence and severity of periodontal disease in women with PPROM. The secondary aim was to characterize an association between periodontal status and the presence of intra-amniotic PPROM complications (MIAC and/or IAI). Seventy-eight women with PPROM at gestational ages between 24 + 0 and 36 + 6 weeks were included in this study. The samples of amniotic fluid were obtained at admission via transabdominal amniocentesis, and amniotic fluid interleukin (IL)-6 concentrations were determined using a point-of-care test. All women had a full-mouth recording to determine the periodontal and oral hygiene status. Probing pocket depth and clinical attachment loss were measured at four sites on each fully erupted tooth. In total, 45% (35/78) of women with PPROM had periodontal disease. Mild, moderate, and severe periodontal disease was present in 19% (15/78), 19% (15/78), and 6% (5/78) of women, respectively. The presence of MIAC and IAI was found in 28% (22/78) and 26% (20/78) of women, respectively. Periopathogenic bacteria (2 × Streptococcus intermedius and 1 × Fusobacterium nucleatum) was found in the amniotic fluid of 4% (3/78) of women. There were no differences in periodontal status between women with MIAC and/or IAI and women without these intra-amniotic complications. The presence of MIAC and IAI was not related

  10. Sterile and Microbial-associated Intra-amniotic Inflammation in Preterm Prelabor Rupture of Membranes

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    Romero, Roberto; Miranda, Jezid; Chaemsaithong, Piya; Chaiworapongsa, Tinnakorn; Kusanovic, Juan P.; Dong, Zhong; Ahmed, Ahmed I.; Shaman, Majid; Lannaman, Kia; Yoon, Bo Hyun; Hassan, Sonia S.; Kim, Chong J.; Korzeniewski, Steven J.; Yeo, Lami; Kim, Yeon Mee

    2017-01-01

    Objective The objectives of this study were to: 1) determine the amniotic fluid (AF) microbiology of patients with preterm prelabor rupture of membranes (PROM); and 2) examine the relationship between intra-amniotic inflammation with and without microorganisms (sterile inflammation) and adverse pregnancy outcomes in patients with preterm PROM. Methods AF samples obtained from 59 women with preterm PROM were analyzed using cultivation techniques (for aerobic and anaerobic bacteria as well as genital mycoplasmas) and with broad-range polymerase chain reaction coupled with electrospray ionization mass spectrometry (PCR/ESI-MS). AF concentration of interleukin-6 (IL-6) was determined using ELISA. Results of both tests were correlated with AF IL-6 concentrations, and the occurrence of adverse obstetrical/perinatal outcomes. Results 1) PCR/ESI-MS, AF culture, and the combination of these two tests, each identified microorganisms in 36% (21/59), 24% (14/59) and 41% (24/59) of women with preterm PROM, respectively; 2) the most frequent microorganisms found in the amniotic cavity were Sneathia species and Ureaplasma urealyticum; 3) the frequency of microbial-associated and sterile intra-amniotic inflammation was overall similar [ 29% (17/59)]: - however, the prevalence of each differed according to the gestational age when PROM occurred ; 4) the earlier the gestational age at preterm PROM, the higher the frequency of both microbial-associated and sterile intra-amniotic inflammation; 5) the intensity of the intra-amniotic inflammatory response against microorganisms is stronger when preterm PROM occurs early in pregnancy; and 6) the frequency of acute placental inflammation (histologic chorioamnionitis and/or funisitis) was significantly higher in patients with microbial-associated intra-amniotic inflammation than in those without intra-amniotic inflammation [93.3% (14/15) vs. 38% (6/16); p=0.001]. Conclusions 1) The frequency of microorganisms in preterm PROM is 40% using

  11. Induction of labor versus expectant management in women with preterm prelabor rupture of membranes between 34 and 37 weeks: A randomized controlled trial

    NARCIS (Netherlands)

    D.P. van der Ham (David); S.M.C. Vijgen (Sylvia); J.G. Nijhuis (Jan); J.J. van Beek (Johannes); B.C. Opmeer (Brent); A.L.M. Mulder; R.M.J. Moonen (Rob); M. Groenewout (Mariette); M.G. van Pampus (Marielle); G.D. Mantel (Gerald); K.W.M. Bloemenkamp (Kitty); W.J. van Wijngaarden (Wim); M.J. Sikkema (Marko); M.C. Haak (Monique); P.J.M. Pernet (Paula); M. Porath (Martina); J.F.M. Molkenboer (Jan); S. Kuppens (Simone); A. Kwee (Anneke); M.M. Kars (Michael M.); M.D. Woiski (Mallory); M.J.N. Weinans (Martin); H.I.J. Wildschut (Hajo); B.M.C. Akerboom (Bettina); B.W.J. Mol (Ben); C. Willekes (Christine)

    2012-01-01

    textabstractBackground: At present, there is insufficient evidence to guide appropriate management of women with preterm prelabor rupture of membranes (PPROM) near term. Methods and Findings: We conducted an open-label randomized controlled trial in 60 hospitals in The Netherlands, which included no

  12. Induction of Labor versus Expectant Management in Women with Preterm Prelabor Rupture of Membranes between 34 and 37 Weeks : A Randomized Controlled Trial

    NARCIS (Netherlands)

    van der Ham, David P.; Vijgen, Sylvia M. C.; Nijhuis, Jan G.; van Beek, Johannes J.; Opmeer, Brent C.; Mulder, Antonius L. M.; Moonen, Rob; Groenewout, Mariet; van Pampus, Marielle G.; Mantel, Gerald D.; Bloemenkamp, Kitty W. M.; van Wijngaarden, Wim J.; Sikkema, Marko; Haak, Monique C.; Pernet, Paula J. M.; Porath, Martina; Molkenboer, Jan F. M.; Kuppens, Simone; Kwee, Anneke; Kars, Michael E.; Woiski, Mallory; Weinans, Martin J. N.; Wildschut, Hajo I. J.; Akerboom, Bettina M. C.; Mol, Ben W. J.; Willekes, Christine

    2012-01-01

    Background: At present, there is insufficient evidence to guide appropriate management of women with preterm prelabor rupture of membranes (PPROM) near term. Methods and Findings: We conducted an open-label randomized controlled trial in 60 hospitals in The Netherlands, which included non-laboring w

  13. Induction of labor versus expectant management in women with preterm prelabor rupture of membranes between 34 and 37 weeks: a randomized controlled trial

    NARCIS (Netherlands)

    Ham, D.P. van der; Vijgen, S.M.; Nijhuis, J.G.; Beek, J.J. van; Opmeer, B.C.; Mulder, A.L.; Moonen, R.; Groenewout, M.; Pampus, M.G. van; Mantel, G.D.; Bloemenkamp, K.W.; Wijngaarden, W.J. van; Sikkema, M.; Haak, M.C.; Pernet, P.J.; Porath, M.; Molkenboer, J.F.; Kuppens, S.; Kwee, A.; Kars, M.E.; Woiski, M.D.; Weinans, M.J.; Wildschut, H.I.J.; Akerboom, B.M.; Mol, B.W.; Willekes, C.; group, P.t.

    2012-01-01

    BACKGROUND: At present, there is insufficient evidence to guide appropriate management of women with preterm prelabor rupture of membranes (PPROM) near term. METHODS AND FINDINGS: We conducted an open-label randomized controlled trial in 60 hospitals in The Netherlands, which included non-laboring w

  14. RESEARCH ON REDUCING PREMATURITY RUPTURE OF MEMBRANE

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    Maria URSACHI (BOLOTA

    2016-12-01

    Full Text Available The membranes surrounding the amniotic cavity are composed from amnion and chorion, tightly adherent layers which are composed of several cell types, including epithelial cells, trophoblasts cells and mesenchyme cells, embedded in a collagenous matrix. They retain amniotic fluid, secret substances into the amniotic fluid, as well as to the uterus and protect the fetus against upward infections from urogenital tract. Normally, the membranes it breaks during labor. Premature rupture of the amniotic sac (PRAS is defined as rupture of membranes before the onset of labor. Premature rupture of the fetal membrane, which occurs before 37 weeks of gestation, usually, refers to preterm premature rupture of membranes. Despite advances in the care period, premature rupture of membranes and premature rupture of membranes preterm continue to be regarded as serious obstetric complications. On the term 8% - 10% of pregnant women have premature rupture of membranes; these women are at increased risk of intrauterine infections, where the interval between membrane rupture and expulsion is rolled-over. Premature rupture of membranes preterm occurs in approximately 1% of all pregnancies and is associated with 30% -40% of preterm births. Thus, it is important to identify the cause of pre-term birth (after less than 37 completed weeks of "gestation" and its complications, including respiratory distress syndrome, neonatal infection and intraventricular hemorrhage. Objectives: the development of the protocol of the clinical trial on patients with impending preterm birth, study clinical and statistical on the socio-demographic characteristics of patients with imminent preterm birth; clinical condition of patients and selection of cases that could benefit from the application of interventional therapy; preclinical investigation (biological and imaging of patients with imminent preterm birth; the modality therapy; clinical investigation of the effectiveness of short

  15. Preterm prelabor rupture of membranes and outcome of very-low-birth-weight infants in the German Neonatal Network.

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    Kathrin Hanke

    Full Text Available It was the aim of our study to evaluate the independent effect of preterm prelabor rupture of membranes (PPROM as a cause of preterm delivery on mortality during primary hospital stay and significant morbidities in very-low-birth-weight (VLBW infants < 32 weeks of gestation.Observational, epidemiological study design.Population-based cohort, German Neonatal Network (GNN.6102 VLBW infants were enrolled in GNN from 2009-2012, n=4120 fulfilled criteria for primary analysis (< 32 gestational weeks, no pre-eclampsia, HELLP (highly elevated liver enzymes and low platelets syndrome or placental abruption as cause of preterm birth.Multivariable logistic regression analyses included PPROM as potential risk factors for adverse outcomes and well established items such as gestational age in weeks, birth weight, antenatal steroids, center, inborn delivery, multiple birth, gender and being small-for-gestational-age.PPROM as cause of preterm delivery had no independent effect on the risk of early-onset sepsis, clinical sepsis and blood-culture proven sepsis, while gestational age proved to be the most important contributor to sepsis risk. The diagnosis of PPROM was associated with an increased risk for bronchopulmonary dysplasia (BPD; OR: 1.25, 95% CI: 1.02-1.55, p=0.03 but not with other major outcomes.The diagnosis of PPROM per se is not associated with adverse outcome in VLBW infants < 32 weeks apart from a moderately increased risk for BPD. Randomized controlled trials with primary neonatal outcomes are needed to determine which subgroup of VLBW infants benefit from expectant or intentional management of PPROM.

  16. NEONATAL COMPLICATIONS OF PREMATURE RUPTURE OF MEMBRANES

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    F. Nili AA. Shams Ansari

    2003-07-01

    Full Text Available Premature rupture of membranes (PROM is one of the most common complications of pregnancy that has a major impact on neonatal outcomes. With respect to racial, nutritional and cultural differences between developed and developing countries, this study was conducted to detect the prevalence of neonatal complications following PROM and the role of the duration of rupture of membranes in producing morbidities and mortalities in these neonates in our hospital. Among 2357 pregnant women, we found 163 (6.91% cases of premature rupture of the fetal membranes in Tehran Vali-e-Asr Hospital during April 2001 to April 2002. Route of delivery was cesarean section in 65.6% of women. Urinary tract infection occured in 1.8%, maternal leukocytosis and fever in 20.2% and 5.5%, chorioamnionitis in 6.1%, fetal tachycardia in 1.2% and olygohydramnios in 4.9%. Gestational age in 138 (86% of neonates was less than 37 completed weeks. Thirty five infants (21.47% had respiratory distress syndrome and 33 (20.245% had clinical sepsis. Pneumonia in 6 (3.7% and skeletal deformity in 7 (4.294% were seen. Rupture of membrane of more than 24 hours duration occurred in 71 (43.6% of the patients. Comparison of morbidities between two groups of neonates and their mothers according to the duration of PROM (less and more than 24 hours showed significant differences in NICU admission, olygohydramnios, maternal fever, leukocytosis and chorioamnionitis rates (p24 hr of PROM with an odds ratio of 2.68 and 2.73, respectively. Positive blood and eye cultures were detected in 16 cases during 72 hours of age. Staphylococcus species, klebsiella, E.coli and streptococcus were the predominant organisms among positive blood cultures. Mortality was seen in 18 (11% of neonates because of respiratory failure, disseminated intravascular coagulation, septic shock, and a single case of congenital toxoplasmosis. In this study, the prevalence of prematurity, sepsis and prolonged rupture of membrane

  17. Diagnostic Modalities in Premature Rupture of Membranes

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    Fatma Eskicioğlu

    2015-04-01

    Full Text Available Objectives: Rupture of membranes prior to the onset of labor is known as Premature Rupture of Membranes (PROM. Early and correct diagnosis is crucial in order to prevent fetal and maternal risks that can be life threatening. We aimed to investigate the diagnostic ability of the tests in PROM. Materials and Methods: Nitrazine test, fern test, amnio-dye test, biochemical tests (insulin-like growth factor binding protein-1 and placental alpha microglobulin-1 were evaluated in terms of effectiveness in diagnosis of PROM. Results: A gold standard method has not yet been defined in PROM. Diagnostic tests (nitrazine test, fern test, Insulin-like Growth Factor Binding Protein-1 “IGFBP-1” and Placental Alpha Microglobulin-1 “PAMG-1” should be used when the diagnosis is not certain following history, examination with sterile speculum and ultrasonography evaluation. Conclusion: IGFBP-1 and PAMG-1 are tests based on bedside immunochromatographic method. Especially, PAMG-1 comes into prominence with its high sensitivity and specificity.

  18. [Histologic chorioamnionitis prevalence in patients with premature rupture membranes].

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    Garcia-de la Torre, José Ignacio; Delgado-Rosas, Antonio; Gonzélez-Cantú, Gerardo

    2014-12-01

    Search Histologic Chorioamnionitis frequency in patients in week 28 (+/-) and pregnancy with premature rupture of membranes. Retrospective and observational study in which we studied all patients who came between June 28, 2011 and November 15, 2011 to receive obstetric care in the service of Tocochirurgical of the University Hospital of Saltillo, with greater than or equal 28 weeks of pregnancy. 598 patients were studied, and the frequency of premature rupture of membranes with histologic chorioamnionitis at term patients was, respectively, 1.7 and 5.3% in preterm labor. In the total sample frequency of histologic chorioamnionitis was 0.6% (4 patients) and, of these, 25% were term and 75% with preterm rupture. In patients with premature rupture of membranes the clinical chorioamnionitis was 0% valued by the criteria of Gibbs. The premature rupture of membranes is a risk factor important for histological chorioamnionitis. To decrease risk factors and possible complications, an established protocol must be taken.

  19. Premature rupture of membranes at term: immediate induction of ...

    African Journals Online (AJOL)

    Premature rupture of membranes at term: immediate induction of labor versus expectant ... AFRICAN JOURNALS ONLINE (AJOL) · Journals · Advanced Search · USING ... Methods: One hundred and fifty two women with PROM at term were ...

  20. Accuracy of imaging parameters in the prediction of lethal pulmonary hypoplasia secondary to mid-trimester prelabor rupture of fetal membranes: a systematic review and meta-analysis.

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    van Teeffelen, A S P; Van Der Heijden, J; Oei, S G; Porath, M M; Willekes, C; Opmeer, B; Mol, B W J

    2012-05-01

    In women who have suffered mid-trimester prelabor rupture of membranes (PPROM), prediction of pulmonary hypoplasia is important for optimal management. We performed a systematic review to assess the capacity of imaging parameters to predict pulmonary hypoplasia. We searched for published articles that reported on biometric parameters and allowed the construction of a 2 × 2 table, comparing at least one of these parameters with the occurrence of pulmonary hypoplasia. The selected studies were scored on methodological quality and we calculated sensitivity and specificity of the tests in the prediction of pulmonary hypoplasia and lethal pulmonary hypoplasia. Overall performance was assessed by summary receiver-operating characteristics (sROC) analyses that were performed with bivariate meta-analysis. We detected 13 studies that reported on the prediction of lethal pulmonary hypoplasia. The quality of the included studies was poor to mediocre. The estimated sROC curves for the chest circumference/abdominal circumference ratio and other parameters showed limited accuracy in the prediction of pulmonary hypoplasia. In women with mid-trimester PPROM, the available evidence indicates limited accuracy of biometric parameters in the prediction of pulmonary hypoplasia.

  1. PERINATAL AND MATERNAL OUTCOME IN PREMATURE RUPTURE OF MEMBRANES

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    Mercy Rodrigo

    2016-06-01

    Full Text Available BACKGROUND The objectives of this study are 1 To find out the incidence of premature rupture of membranes, 2 To evaluate the aetiology of premature rupture of membranes, 3 To assess foetal and maternal outcome in premature rupture of membranes. MATERIAL AND METHODS This prospective case control study was conducted in Govt. RSRM Lying In Hospital, Chennai, over a period of 6 months and 100 cases of spontaneous rupture of membranes attending the Department of Obstetrics and Gynaecology were studied. Maternal and neonatal outcome were compared with controls. RESULTS Incidence of PROM was 9.06%. Most of them belonged to low socioeconomic class and in the age group 20-29 years, commonly seen primi gravida and in unbooked cases. Aetiological analysis revealed infection in 15% of cases, which is evident by positive amniotic fluid culture, h/o recent coitus in 20%, mal-presentation in 7%. Cause is unknown in most of the cases. The caesarean section rate is 24% when compared to 12% in control group. The PROM group had higher morbidities like postpartum haemorrhage, postpartum fever, wound infection, neonatal sepsis. CONCLUSION This study showed significantly increased morbidity for both mother and baby. PROM causes major increase in the incidence of prematurity, hence careful screening of high risk factors and treatment of infection promptly is needed to decrease the perinatal morbidity and mortality.

  2. The clinical and microbiological correlates of premature rupture of membranes

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    Karat C

    2006-01-01

    Full Text Available Prematurity is the cause of 85% of neonatal morbidity and mortality. Premature rupture of the membranes (PROM is associated with 30-40% of preterm deliveries. A case-control study conducted between July 2002 and 2003 examined the correlates and risk factors for PROM in Mysore, India. WBCs in vaginal fluid, leucocytes in urine, UTI and infection with E . coli , S . aureus , C. albicans and BV were significantly associated with PROM. BV, E. coli and WBCs in vaginal fluid were independent risk factors. Screening and treatment of BV and E. coli infection in pregnancy may reduce the risk of PROM.

  3. [Preterm premature rupture of membranes: active or expectant management?].

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    Kayem, G; Maillard, F

    2009-04-01

    Preterm premature rupture of membranes (PPROM) occurs in 3% of pregnancies and is responsible for 30% of preterm births. The management is discussed between active and expectant management. French recommendations let open both possibilities. The risks described in the case of PPROM are those of prematurity, maternofetal infection, acute procidence of the umbilical cord and abruptio placentae. Before 32 weeks of gestation (WG) and even 34 WG, a prolongation of one week of gestational age significantly decreases neonatal mortality and morbidity. Therefore, most of the authors choose expectant management in case of PPROM. Between 34 and 37 WG, the risk of rare severe morbidity associated with prematurity has to be balanced with risks of an acute maternofetal infection and of abruptio placentae. Further randomized trials are required to choose a type of management with a sufficient level of evidence.

  4. Maternal and perinatal outcomes in premature rupture of membranes

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    Maissa Marçola Scandiuzzi

    2014-12-01

    Full Text Available Introducion: pregnancies complicated by premature rupture of membranes (PROM are associated with bad outcomes and controvertial management. Although underlain mechanism is unknown, strong evidences point infection as the main cause underneath preterm premature rupture of membranes and preterm labour. Objective: to determine maternal and neonatal outcomes in pregnancies complicated by premature rupture of membranes. Method: retrospective analysis of maternal and neonatal outcomes of pregnancies complicated by PROM at University Hospital of Faculdade de Medicina Jundiaí, from march 2007 to june 2009. Results: the results showed a higher prevalence: age between 20 and 30 years (54.5%, caucasian (58.6%, unmarried (46%, non-smokers (72.82%, gestation LMP term (63.3% and USG (64.5%, number of prenatal consultations more than six (59.8%, multiparous (66.6%, obstetric history with normal vaginal delivery (PVN (56.3%, cervical dilatation at admission between 2 cm - 3 cm, evanescence 50%, ruptured membranes between 1 and 4 hours, conduct the spontaneous delivery (82.5%, type of delivery PVN (55,6%, newborn weighing 2,500 kg and 3,500 kg (61.6%, Apgar score greater than seven at 1 and 5 minutes (89.2% and 99.2% respectively, need for resuscitation (81,5%, Neo ICU (2.6% and length of the binomial two days. Conclusion: based on our results and in comparison with the literature review, we found a similar prevalence in our service and other services of those studies. The exception was the high prevalence of cesarean section over the other and the high number of pregnant women had not received prenatal care (22.9%.

  5. Induction of labor versus expectant management in women with preterm prelabor rupture of membranes between 34 and 37 weeks: a randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    David P van der Ham

    Full Text Available BACKGROUND: At present, there is insufficient evidence to guide appropriate management of women with preterm prelabor rupture of membranes (PPROM near term. METHODS AND FINDINGS: We conducted an open-label randomized controlled trial in 60 hospitals in The Netherlands, which included non-laboring women with >24 h of PPROM between 34(+0 and 37(+0 wk of gestation. Participants were randomly allocated in a 1:1 ratio to induction of labor (IoL or expectant management (EM using block randomization. The main outcome was neonatal sepsis. Secondary outcomes included mode of delivery, respiratory distress syndrome (RDS, and chorioamnionitis. Patients and caregivers were not blinded to randomization status. We updated a prior meta-analysis on the effect of both interventions on neonatal sepsis, RDS, and cesarean section rate. From 1 January 2007 to 9 September 2009, 776 patients in 60 hospitals were eligible for the study, of which 536 patients were randomized. Four patients were excluded after randomization. We allocated 266 women (268 neonates to IoL and 266 women (270 neonates to EM. Neonatal sepsis occurred in seven (2.6% newborns of women in the IoL group and in 11 (4.1% neonates in the EM group (relative risk [RR] 0.64; 95% confidence interval [CI] 0.25 to 1.6. RDS was seen in 21 (7.8%, IoL versus 17 neonates (6.3%, EM (RR 1.3; 95% CI 0.67 to 2.3, and a cesarean section was performed in 36 (13%, IoL versus 37 (14%, EM women (RR 0.98; 95% CI 0.64 to 1.50. The risk for chorioamnionitis was reduced in the IoL group. No serious adverse events were reported. Updating an existing meta-analysis with our trial results (the only eligible trial for the update indicated RRs of 1.06 (95% CI 0.64 to 1.76 for neonatal sepsis (eight trials, 1,230 neonates and 1.27 (95% CI 0.98 to 1.65 for cesarean section (eight trials, 1,222 women for IoL compared with EM. CONCLUSIONS: In women whose pregnancy is complicated by late PPROM, neither our trial nor the updated meta

  6. Raised Vaginal Fluid Fibronectin Level Indicates Premature Rupture of Membrane

    Directory of Open Access Journals (Sweden)

    Amrita Bhowmik

    2012-07-01

    Full Text Available Background: Premature rupture of membrane (PROM is one of the common complications of pregnancy that has major impact on fetal and neonatal outcome. It is the commonest clinical event where a normal pregnancy becomes suddenly a high-risk one for mother and fetus or neonate. Objective: The study was undertaken to investigate whether raised fibronectin level in vaginal fluid may indicate premature rupture of membrane. Materials and Methods: This cross sectional study was conducted in the department of Obstetrics and Gynecology in Sir Salimullah Medical College & Mitford Hospital, Dhaka during the period of January 2006 to December 2007. A total of 114 pregnant women with gestational age 28th week up to 40th week were included. Sixty were PROM (Group I and 54 were non-PROM (Group II subjects. Fibronectin in vaginal fluid was measured by an immunochemical reaction by nephelometer. Statistical analysis was done by SPSS version 10.0. Results: The PROM patients had significantly higher concentration of fibronectin (225.77 ± 115.18 ng/mL compared to that in non-PROM subjects (8.04 ± 16.17 ng/mL (p < 0.001. Conclusion: It can be concluded that in cases of unequivocal rupture or intactness of the membranes, the result of the fibronectin test corresponds well with the clinical situation. So fibronectin is a sensitive test for detection of amniotic fluid in the vagina.

  7. [Properties of the chorioamnios zone inducing premature membranes rupture].

    Science.gov (United States)

    Meraz Cruz, M C Noemí; Beltrán Montoya, Jorge; Bustos López, Hugo; Flores Pliego, Arturo; Espejel, Aurora; Buendía Díaz, Gerardo; Vadillo-Ortega, Felipe

    2003-11-01

    Premature membrane rupture (PMR) is one of the most serious public health problems in the world, ocurring in 10% of all pregnancies. PMR has important adverse effects on maternofetal morbidity-mortality, as it has been estimated that it accounts on the whole for 70% and 40% of neonatal morbidity and mortality, respectively. PMR treatment is empirical, as its aetiology is unknown and its physiopathogenic description has just been initiated. This work analyzes the possibility of documenting functional differences in human chorio-amnios, comparing the zone where rupture most frequently occurs in PMR with some other distant chorio-amnionic zones and with equivalent zones of fetal membranes obtained from nine month pregnancies which have not undergone labor. The membrane zone which was nearest to the cervical os was identified and marked to be analyzed later for extracellular matrix metalloprotease (MMP) activity, histology and topographical MMP distribution. The MMP expression was quantitatively determined in explant culture media from membrane fragments using specific immuno-enzymatic essays (ELISA) and zymography. In addition, immuno-histochemistry methods were used to reveal MMP expression in the different tissues. This methods allowed us to show the existence of a decreasing MMP activity gradient, with the greatest value corresponding to the zone nearest to the cervical os in the membranes obtained from PMR cases. In membranes obtained from cesarean operations no characteristic pattern was documented and values were always lower than those obtained for PMR tissues. We conclude that there is a chorio-amnionic zone in which connective tissue degradation is specifically induced and which coincides with the membrane zone in contact with the cervical os.

  8. AmniSure: A Point of Care Diagnostic for Preterm, Term Prelabor ...

    African Journals Online (AJOL)

    AmniSure: A Point of Care Diagnostic for Preterm, Term Prelabor. Rupture of ... alpha‑microglobulin‑1 test for accurate diagnosis of true ROM in women with watery discharge after 28 weeks gestation, ..... resource-limited community settings.

  9. Air pollution and preterm premature rupture of membranes : A spatiotemporal analysis

    NARCIS (Netherlands)

    Dadvand, Payam; Basagaña, Xavier; Figueras, Francesc; Martinez, David; Beelen, Rob|info:eu-repo/dai/nl/30483100X; Cirach, Marta; De Nazelle, Audrey; Hoek, Gerard|info:eu-repo/dai/nl/069553475; Ostro, Bart; Nieuwenhuijsen, Mark J.

    2014-01-01

    Preterm premature rupture of membranes (PROM) is the leading identifiable predisposing factor for preterm birth. Although maternal exposure to air pollution can potentially have an impact on preterm PROM, there is no available evidence on such an impact. In this study, based on 5,555 singleton

  10. LABOUR INDUCTION WITH INTRAVAGINAL MISOPROSTOL VERSUS OXYTOCIN IN TERM PREMATURE RUPTURE OF MEMBRANES

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    Suhas

    2014-12-01

    Full Text Available Labour Induction with intravaginal Misoprostol versus Oxytocin in Term Premature Rupture of Membranes. OBJECTIVES: To compare the safety and efficacy of misoprostol with oxytocin for labour induction in women with premature rupture of membranes b eyond 36 weeks gestation. METHODS: 65 subjects with rupture of membranes without labour were assigned to receive. vaginally administered misoprostol 50 ug, every 4 hrs. and another 65 subjects with rupture of membranes at term received intravenous oxytocin infusion and we compared the duration of labour, intrapartu m complications, mode of delivery and the maternal and neonatal outcomes in the two groups. RESULTS: R esults of the 130 subjects studied, 65 received misoprostol and 65 oxytocin infusion. The average interval, from start of induction vaginal delivery was significantly shorter (660 minutes in the misoprostol group than the oxytocin group (1105 min . Oxytocin administration was necessary in 13 (20% subjects receiving misoprostol. There was incr eased incidence of tachysystole in misorpostol group 22 (33.8% compared to the oxytocin group 9 (13.8% No significant difference was found in the mode of delivery neonatal and maternal outcomes in the two groups . CONCLUSION: Vaginal administration of misorpostol is safe and effective alternative to oxytocin infusion for labour induction in women with premature rupture of membranes at term.

  11. Visfatin/Pre-B Cell Colony-Enhancing Factor in Amniotic Fluid in Normal Pregnancy, Spontaneous Labor at Term, Preterm Labor and Prelabor Rupture of Membranes: an Association with Subclinical Intrauterine Infection in Preterm Parturition

    Science.gov (United States)

    Mazaki-Tovi, Shali; Romero, Roberto; Kusanovic, Juan Pedro; Erez, Offer; Gotsch, Francesca; Mittal, Pooja; Than, Nandor Gabor; Nhan-Chang, Chia-lang; Hamill, Neil; Vaisbuch, Edi; Chaiworapongsa, Tinnakorn; Edwin, Samuel S.; Nien, Jyh Kae; Gomez, Ricardo; Espinoza, Jimmy; Kendal-Wright, Claire; Hassan, Sonia S.; Bryant-Greenwood, Gillian

    2008-01-01

    Objective Visfatin, a novel adipokine originally discovered as a pre-B-cell colony enhancing factor, is expressed by amniotic epithelium, cytotrophoblast, and decidua and is over-expressed when fetal membranes are exposed to mechanical stress and/or pro-inflammatory stimuli. Visfatin expression by fetal membranes is dramatically up-regulated after normal spontaneous labor. The aims of this study were to determine if visfatin is detectable in amniotic fluid (AF) and whether its concentration changes with gestational age, spontaneous labor, preterm prelabor rupture of membranes (preterm PROM) and in the presence of microbial invasion of the amniotic cavity (MIAC). Methods In this cross-sectional study, visfatin concentration in AF was determined in patients in the following groups: 1) mid-trimester (n=75); 2) term not in labor (n=27); 3) term in spontaneous labor (n=51); 4) patients with preterm labor with intact membranes (PTL) without MIAC who delivered at term (n=35); 5) patients with PTL without MIAC who delivered preterm (n=52); 6) patients with PTL with MIAC (n=25); 7) women with preterm PROM without MIAC (n=26); and 8) women with preterm PROM with MIAC (n=26). Non-parametric statistics were used for analysis. Results 1) The median AF concentration of visfatin was significantly higher in patients at term than in midtrimester; 2) Among women with PTL who delivered preterm, the median visfatin concentration was significantly higher in patients with MIAC than those without MIAC; 3) Similarly, patients with PTL and MIAC had a higher median AF visfatin concentration than those with PTL who delivered at term; 4) Among women with preterm PROM, the median AF visfatin concentration was significantly higher in patients with MIAC than those without MIAC. Conclusions 1) Visfatin is a physiologic constituent of AF; 2) The concentration of AF visfatin increases with advancing gestational age; 3) AF visfatin concentration is elevated in patients with MIAC, regardless of the

  12. The significance of C-reactive protein levels in women with premature rupture of membranes.

    Science.gov (United States)

    Ismail, M A; Zinaman, M J; Lowensohn, R I; Moawad, A H

    1985-02-15

    In a prospective study of 100 patients with preterm premature rupture of membranes, clinical chorioamnionitis was present in 18 and histologic chorioamnionitis was present in 63. Patients who were managed conservatively for premature rupture of membranes were monitored by C-reactive protein determination, white blood cell and differential counts, maternal temperature, and fetal heart tone. C-reactive protein was measured nephelometrically (Immuno-chemistry Analyzer II, Beckman). Elevated C-reactive protein levels correlated well with both the pathologic and the clinical diagnosis of chorioamnionitis. Elevated C-reactive protein levels (at least 12 to 24 hours before delivery) were more sensitive than other standard laboratory or clinical tests in predicting chorioamnionitis both by clinical and pathologic criteria. When C-reactive protein values were normal, clinical chorioamnionitis was rarely found, whereas pathologically diagnosed chorioamnionitis was found half of the time. We conclude that although the C-reactive protein level is a very sensitive predictor of infectious morbidity in premature rupture of membranes, its specificity is not high.

  13. The experience of women in hospital rest with preterm premature rupture of de amniotic membranes

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    María del Mar Fernández Míguez

    2012-07-01

    Full Text Available Hospital bed rest in a preterm premature rupture of the amniotic membranes involves a crisis situation for women with very high emotional effects.To understand the needs felt of the gestantes with pregnancies of high risk on the part of the professionals, it will improve the quality of the attention and it can help to diminish the stress levels at this vulnerable period and to confronting the maternity.Aim: Investigate women´s experience when they are resting in hospital in cases de preterm premature rupture of membranes.Methodology: Phenomenological study, It has taken as a population of study to women hospitalized in the plant of obstetrics of high risk from Gregorio Marañón Hospital, with preterm premature rupture of membranes between 24 and 31 weeks of gestation.Data collection: Was be carried out by means of the individual interviews in hospitable environment; observation and withdrawal of notes during the accomplishment of this one.

  14. Effect of magnesium sulfate administration for neuroprotection on latency in women with preterm premature rupture of membranes.

    LENUS (Irish Health Repository)

    Horton, Amanda L

    2015-03-01

    This study aims to evaluate whether magnesium sulfate administration for neuroprotection prolongs latency in women with preterm premature rupture of membranes (PPROM) between 24 and 31(6\\/7) weeks\\' gestation.

  15. Randomized Trial of Vaginal Prostaglandin E2 Versus Oxytocin for Labor Induction in Term Premature Rupture of Membranes

    National Research Council Canada - National Science Library

    Kunt, Cigdem; Kanat-Pektas, Mine; Gungor, Ayse Nur Cakir; Kurt, Raziye Keskin; Ozat, Mustafa; Gulerman, Cavidan; Gungor, Tayfun; Mollamahmutoglu, Leyla

    2010-01-01

    ...) vaginal insert with those of oxytocin for labor induction. The present study also examined whether its use reduces the rate of cesarean delivery in term pregnancies with premature rupture of membranes (PROM...

  16. Comparison of Crp and Ferritin Levels in Preterm Labor and Premature Membrane Ruptured Cases

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    Yasemin Cekmez

    2014-03-01

    Full Text Available Aim: Premature ruptur of membranes (PROM means the rupture of membranes at least one hour before the active labor begins.It is named as preterm premature rupture of membranes( PretermPROM if the rupture occurs before the 37th weeks of gestation.Although the etiologies,complications and results of the PROM and PretermPROM are similar,it has been showed that the major reason for the PretermPROM is infection in choriodesidual unit. Material and Method: It is important to identify the maternal infection for protection against the negative outcomes of prematurity and preterm labor.To obtain the probable maternal infection we can use serum markers of inflamation like leucocyte count,C-reactive protein,ALP,beta-2 microglobulin,alfa-2 macroglobulin. Results: We observed the serum levels of CRP and ferritin in PROM and PretermPROM diagnosed patients.The aim of this trial was to asses the differences of serum CRP and fibrinogen consantrations in selected PROM and PretermPROM diagnosed cases to emphasize the importance of subclinical infection in these diseases. Discussion: According to the results of our trial we found that CRP levels were in normal range in control group but significantly higher in group with PROM and Preterm PROM.In groups with PROM and Preterm PROM avarege value of ferritin was significantly higher than control group.Present results supports that serum ferritin and CRP levels are useful for follow-up possible infections in pregnant women with PROM and Preterm PROM.

  17. Preterm premature rupture of the fetal membranes: association with sociodemographic factors and maternal genitourinary infections

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    Arnildo A. Hackenhaar

    2014-04-01

    Full Text Available OBJECTIVE: tthis study aimed to investigate the incidence of premature rupture of fetal membranes in preterm singleton pregnancies and its association with sociodemographic factors and maternal self-reported genitourinary infections. METHODS: this was a population-based cross-sectional study, which included all mothers of newborns of singleton deliveries that occurred in 2010, with birth weight > 500 grams, who resided in the city of Rio Grande. Women were interviewed in the two maternity hospitals. Cases were women who had lost amniotic fluid before hospitalization and whose gestational age was less than 37 weeks. Statistical analysis was performed by levels to control for confounding factors using Poisson regression. RESULTS: of the 2,244 women eligible for the study, 3.1% had preterm premature rupture of fetal membranes, which was more frequent, after adjustment, in women of lower socioeconomic status, (prevalence ratio [PR] = 1.94, with lower level of schooling (PR = 2.43, age > 29 years (PR = 2.49, and smokers (PR = 2.04. It was also associated with threatened miscarriage (PR = 1.68 and preterm labor, (PR = 3.40. There was no association with maternal urinary tract infection or presence of genital discharge. CONCLUSIONS: the outcome was more common in puerperal women with lower level of schooling, lower socioeconomic status, older, and smokers, as well as those with a history of threatened miscarriage and premature labor. These factors should be considered in the prevention, diagnosis, and therapy approach.

  18. Preterm premature rupture of the fetal membranes: association with sociodemographic factors and maternal genitourinary infections.

    Science.gov (United States)

    Hackenhaar, Arnildo A; Albernaz, Elaine P; da Fonseca, Tânia M V

    2014-01-01

    this study aimed to investigate the incidence of premature rupture of fetal membranes in preterm singleton pregnancies and its association with sociodemographic factors and maternal self-reported genitourinary infections. this was a population-based cross-sectional study, which included all mothers of newborns of singleton deliveries that occurred in 2010, with birth weight ≥ 500 grams, who resided in the city of Rio Grande. Women were interviewed in the two maternity hospitals. Cases were women who had lost amniotic fluid before hospitalization and whose gestational age was less than 37 weeks. Statistical analysis was performed by levels to control for confounding factors using Poisson regression. of the 2,244 women eligible for the study, 3.1% had preterm premature rupture of fetal membranes, which was more frequent, after adjustment, in women of lower socioeconomic status, (prevalence ratio [PR]=1.94), with lower level of schooling (PR=2.43), age > 29 years (PR=2.49), and smokers (PR=2.04). It was also associated with threatened miscarriage (PR=1.68) and preterm labor, (PR=3.40). There was no association with maternal urinary tract infection or presence of genital discharge. the outcome was more common in puerperal women with lower level of schooling, lower socioeconomic status, older, and smokers, as well as those with a history of threatened miscarriage and premature labor. These factors should be considered in the prevention, diagnosis, and therapy approach. Copyright © 2013 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  19. [Fetal lung development on MRT. Normal course and impairment due to premature rupture of membranes].

    Science.gov (United States)

    Kasprian, G; Brugger, P C; Helmer, H; Langer, M; Balassy, C; Prayer, D

    2006-02-01

    A well-organized interplay between many molecular factors as well as mechanical forces influence fetal lung development. At the end of this complex process a sufficiently sized and structurally mature organ should ensure the postnatal survival of the newborn. Besides prenatal ultrasonography, magnetic resonance imaging (MRI) can now be used to investigate normal and pathological human lung growth in utero. Oligohydramnios, due to premature rupture of membranes (PROM), is an important risk factor for compromised fetal lung growth. In these situations MR volumetry can be used to measure the size of the fetal lung quite accurately. Together with the evaluation of lung signal intensities on T2-weighted sequences, fetuses with pulmonary hypoplasia can be readily detected.

  20. Bacteria localization and chorion thinning among preterm premature rupture of membranes.

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    Kimberly B Fortner

    Full Text Available OBJECTIVE: Bacterial colonization of the fetal membranes and its role in pathogenesis of membrane rupture is poorly understood. Prior retrospective work revealed chorion layer thinning in preterm premature rupture of membranes (PPROM subjects. Our objective was to prospectively examine fetal membrane chorion thinning and to correlate to bacterial presence in PPROM, preterm, and term subjects. STUDY DESIGN: Paired membrane samples (membrane rupture and membrane distant were prospectively collected from: PPROM = 14, preterm labor (PTL = 8, preterm no labor (PTNL = 8, term labor (TL = 10, and term no labor (TNL = 8, subjects. Sections were probed with cytokeratin to identify fetal trophoblast layer of the chorion using immunohistochemistry. Fluorescence in situ hybridization was performed using broad range 16 s ribosomal RNA probe. Images were evaluated, chorion and choriodecidua were measured, and bacterial fluorescence scored. Chorion thinning and bacterial presence were compared among and between groups using Student's t-test, linear mixed effect model, and Poisson regression model (SAS Cary, NC. RESULTS: In all groups, the fetal chorion cellular layer was thinner at rupture compared to distant site (147.2 vs. 253.7 µm, p<0.0001. Further, chorion thinning was greatest among PPROM subjects compared to all other groups combined, regardless of site sampled [PPROM(114.9 vs. PTL(246.0 vs. PTNL(200.8 vs. TL(217.9 vs. TNL(246.5]. Bacteria counts were highest among PPROM subjects compared to all other groups regardless of site sampled or histologic infection [PPROM(31 vs. PTL(9 vs. PTNL(7 vs. TL(7 vs. TNL(6]. Among all subjects at both sites, bacterial counts were inversely correlated with chorion thinning, even excluding histologic chorioamnionitis (p<0.0001 and p = 0.05. CONCLUSIONS: Fetal chorion was uniformly thinner at rupture site compared to distant sites. In PPROM fetal chorion, we demonstrated pronounced global thinning

  1. Length of Latency with Preterm Premature Rupture of Membranes before 32 Weeks’ Gestation

    Science.gov (United States)

    PEACEMAN, Alan M.; LAI, Yinglei; ROUSE, Dwight J.; SPONG, Catherine Y.; MERCER, Brian M.; VARNER, Michael W.; THORP, John M.; RAMIN, Susan M.; MALONE, Fergal D.; O'SULLIVAN, Mary J.; HANKINS, Gary D.V.

    2014-01-01

    Objective To describe latency for patients with preterm premature membrane rupture (PPROM) between 24 0/7 and 31 6/7 weeks’ gestation. Study Design Secondary analysis of data collected prospectively in a multicenter clinical trial of magnesium sulfate for cerebral palsy prevention. Women with PPROM and fewer than 6 contractions per hour at enrollment who were candidates for expectant management (n=1377) were included in this analysis. Length of latency was calculated in days by subtracting the time of delivery from the time of membrane rupture. Results At each week of gestation, median latency between 24-28 weeks was similar at approximately 9 days, but was significantly shorter with PPROM at 29, 30, and 31 weeks (p<0.001). In addition, the percentage of patients remaining undelivered at 7 days and 14 days was similar for PPROM between 24-28 weeks, but decreased significantly after that. For each gestational age, the proportion of patients remaining pregnant declined in a fashion similar to exponential pattern. Conclusion Median latency after PPROM is similar from 24-28 weeks’ gestation, but shortens with PPROM at and after 29 weeks. PMID:24819145

  2. Outcomes after expectant management of extremely preterm premature rupture of the membranes.

    Science.gov (United States)

    Dinsmoor, Mara J; Bachman, Rebecca; Haney, Elaine I; Goldstein, Marci; Mackendrick, William

    2004-01-01

    This study was undertaken to assess contemporary outcomes in pregnancies managed expectantly after extremely preterm premature (< or =24 weeks) premature rupture of the membranes (EPPROM). We queried antepartum and ultrasound databases for patients with EPPROM. Data on pregnancy outcome and short-term neonatal outcomes were collected. Forty-six patients with EPPROM were studied. Patients were hospitalized at 24 weeks' gestation and given antibiotics and antenatal steroids. Median gestational age at PPROM was 22.0 weeks (range 16.9-24 weeks); 43 (93%) elected expectant management, 2 of whom later had an intrauterine fetal death. Median latency period to delivery was 13 days (range 0-96 days), with mean gestational age at delivery of 25.8+/-3.4 weeks. Overall survival was 47% (27 of 57 infants), after a median hospital stay of 71 days (range 17-209 days). Ten (37%) of the survivors have serious sequelae. Although significant pregnancy prolongation after previable PPROM occurs in many cases, neonatal outcomes remain poor.

  3. Survey of Pregnancy Outcome in Preterm Premature Rupture of Membranes with Amniotic Fluid Index <5 and ≥5

    Directory of Open Access Journals (Sweden)

    Fatemeh Tavassoli

    2010-04-01

    Full Text Available Objectives: Preterm premature rupture of membranes (PPROM is among the most important causes of perinatal morbidity and mortality. The aim of this study is to survey the pregnancy outcomes in preterm premature rupture of membranes with an amniotic fluid index of 5.Methods: This prospective cohort study was performed on 137 pregnant women complicated by preterm premature rupture of membranes (PPROM with a gestational age of 28-34 weeks during October 2006 to October 2008. The patients were divided in two groups according to their amniotic fluid index; AFI<5 (77cases, AFI≥5 (60cases. The Chi-squared test for qualitative variables and T-student test for quantitative variables were used to analyze the results.Results: The results showed that there was no significant difference in terms of the number of pregnancies, gestational age at rupture of membranes and birthweight between the two groups. However, the results demonstrated that the patients with AFI<5 exhibited a significantly shorter latency period (p=0.049, a higher rate of cesarean due to fetal distress (p=0.008, a lower neonatal Apgar score in the first minute (p=0.0127 and a higher rate of neonatal death during the first week (p=0.045.Conclusion: Overall, PPROM with oligohydroamnios is associated with shorter latency, higher rate of C/S, higher rate of early neonatal death and lower neonatal Apgar.

  4. Extreme Preterm Premature Rupture of Membranes: Risk Factors and Feto Maternal Outcomes

    Directory of Open Access Journals (Sweden)

    Nihal Al Riyami

    2013-03-01

    Full Text Available Objectives: Preterm premature rupture of membranes (PPROM is defined as a rupture of the amniotic membranes occurring before 37 weeks of gestation and before the onset of labor. Extreme PPROM occurs prior to 26 weeks gestation and contributes to an increased risk of prematurity, leading to maternal and fetal complications. This study aims to estimate the risk factors associated with various maternal complications and to determine the worst outcomes in Omani females with extreme PPROM.Methods: A retrospective cohort study was conducted on 44 women with extreme PPROM, who delivered at Sultan Qaboos University Hospital (SQUH from January 2006 to December 2011. Women with incomplete information, multiple gestations, or a preterm delivery resulting from medical intervention, as well as women who delivered elsewhere were excluded from the study.Results: Forty-four women with extreme PPROM were included in our study. The results revealed the most important risk factor to be history of infection, which was noted in 24 study participants. The mean maternal age was 30 years. The mean gestational age at PPROM and at delivery were 20.7±3.2 (range: 16-26 weeks and 29.7±7.6 weeks (range: 17-40 weeks, respectively. The maternal complications observed in this study included; infection which was seen in 20 (45% patients, antepartum hemorrhage in 11 (25% patients, and cesarean section which was required in 12 (27% patients. There was no significant association between risk factors such as gestational age at delivery, parity, maternal age at PPROM, or maternal Body Mass Index (BMI and cesarean section rate. Infection played a major role, both as a risk factor and in causing extreme PPROM, which in turn increased in 12 patients (27%. In the multivariable model for predicting the need for cesarean section (gestational age at delivery, parity, maternal age at PPROM in years and maternal BMI, none of the factors were statistically significant.Conclusion: Overall

  5. Prolonged latency of preterm premature rupture of membranes and risk of neonatal sepsis.

    Science.gov (United States)

    Drassinower, Daphnie; Friedman, Alexander M; Običan, Sarah G; Levin, Heather; Gyamfi-Bannerman, Cynthia

    2016-06-01

    Preterm premature rupture of membranes (PPROM) is associated with inflammation and infection, and it may involve the loss of a barrier to ascending infection from the vagina, and it is possible that prolonged PPROM could be an independent risk factor for neonatal sepsis. The objective of the study was to determine whether prolonged latency after PPROM is associated with an increased risk of neonatal sepsis. This secondary analysis of the randomized controlled trial of magnesium sulfate for the prevention of cerebral palsy evaluated whether the time interval between diagnosis of PPROM and delivery was associated with an increased risk of neonatal sepsis. Latency time was categorized by weeks of latency (0 weeks to ≥ 4 weeks). The primary outcome was confirmed neonatal sepsis. Logistic regression was used to control for confounders. A total of 1596 patients with PPROM were analyzed, of whom 1390 had a neonatal sepsis occurred in 15.5% of patients in the cohort. In the univariate analysis, patients in the prolonged PPROM group were less likely to have neonatal sepsis (6.8% vs 17.2%, relative risk, 0.40 95% confidence interval, 0.24-0.66). This relationship was retained in the multivariable model; patients with prolonged PPROM ≥ 4 weeks had an adjusted odds ratio of 0.21 (95% confidence interval, 0.10-0.41) for neonatal sepsis. Neonatal sepsis was also significantly associated with earlier gestational age at rupture of membranes. Prolonged exposure to an intrauterine environment of PPROM does not increase the risk of neonatal sepsis; prolonged PPROM ≥ 4 weeks was associated with decreased risk of neonatal sepsis. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Ubiquitin-Proteasome-Collagen (CUP Pathway in Preterm Premature Rupture of Fetal Membranes

    Directory of Open Access Journals (Sweden)

    Xinliang Zhao

    2017-06-01

    Full Text Available Spontaneous preterm birth (sPTB occurs before 37 gestational weeks, with preterm premature rupture of the membranes (PPROM and spontaneous preterm labor (sPTL as the predominant adverse outcomes. Previously, we identified altered expression of long non-coding RNAs (lncRNAs and message RNAs (mRNAs related to the ubiquitin proteasome system (UPS in human placentas following pregnancy loss and PTB. We therefore hypothesized that similar mechanisms might underlie PPROM. In the current study, nine pairs of ubiquitin-proteasome-collagen (CUP pathway–related mRNAs and associated lncRNAs were found to be differentially expressed in PPROM and sPTL. Pathway analysis showed that the functions of their protein products were inter-connected by ring finger protein. Twenty variants including five mutations were identified in CUP-related genes in sPTL samples. Copy number variations were found in COL19A1, COL28A1, COL5A1, and UBAP2 of sPTL samples. The results reinforced our previous findings and indicated the association of the CUP pathway with the development of sPTL and PPROM. This association was due not only to the genetic variation, but also to the epigenetic regulatory function of lncRNAs. Furthermore, the findings suggested that the loss of collagen content in PPROM could result from degradation and/or suppressed expression of collagens.

  7. Conservative management of preterm premature rupture of membranes beyond 32 weeks' gestation: is it worthwhile?

    Science.gov (United States)

    Tsafrir, Z; Margolis, G; Cohen, Y; Cohen, A; Laskov, I; Levin, I; Mandel, D; Many, A

    2015-01-01

    We aimed to investigate whether conservative management of preterm premature rupture of membranes (PPROM) at 32-34 weeks' gestation improves outcome. In this retrospective analysis of singleton pregnancies, the study group included patients with PPROM at 28-34 weeks' gestation and the control group included patients presented with spontaneous preterm delivery at 28-34 weeks' gestation. Both groups were subdivided according to gestational age - early (28-31 weeks' gestation) versus late (32-34 weeks' gestation). Adverse neonatal outcome included neonatal death, intraventricular haemorrhage grade 3/4, respiratory distress syndrome, periventricular leucomalacia and neonatal sepsis. The study and control groups included 94 and 86 women, respectively. The study group had a lower incidence of adverse neonatal outcome at the earlier weeks (28-31), compared with the control group at the same gestational age. In contrast, at 32-34 weeks' gestation no difference in the risk for adverse neonatal outcome was noticed. Additionally, within the study group, chorioamnionitis rate was significantly higher among those who delivered at 32-34 weeks' gestation (p < 0.01). No advantage for conservative management of PPROM was demonstrated beyond 31 weeks' gestation. Moreover, conservative management of PPROM at 32-34 weeks' gestation may expose both mother and neonate to infectious morbidity.

  8. Effectiveness of an exercise program aimed at pregnant institutionalized by premature rupture of membranes (PROM.

    Directory of Open Access Journals (Sweden)

    Enrique Ramón Arbués

    2013-03-01

    Full Text Available In certain circumstances such as premature rupture of membranes (PROM or preterm labor is usually recommended hospital bed rest. But if this is prolonged, may result from negative consequences both physically and emotionally. The aim of this study was to determine the effects of a specific exercise program on physical self-concept and levels of anxiety and depression in a group of pregnant women diagnosed with uncomplicated PROM. A clinical trial was performed on a sample of 50 women diagnosed with uncomplicated RPM at week 32-33 of gestation. In the intervention group performed aerobic exercise routine specifically designed for later (week 34 of gestation to compare their levels of physical self and emotional discomfort (anxiety and depression with a control group with similar characteristics. Results of this investigation show that, in pregnant women uncomplicated diagnostic PROM, a specific exercise program improves physical self-concept and levels of anxiety and depression (p <0.05. Despite recommended further research in this field, does not seem justified the conservative management of complete rest is usually performed in these patients.

  9. Absence of Circadian Rhythms of Preterm Premature Rupture of Membranes and Preterm Placental Abruption

    Science.gov (United States)

    Luque-Fernandez, Miguel Angel; Ananth, Cande V.; Sanchez, Sixto E.; Qiu, Chun-fang; Hernandez-Diaz, Sonia; Valdimarsdottir, Unnur; Gelaye, Bizu; Williams, Michelle A.

    2014-01-01

    Purpose Data regarding circadian rhythm in the onset of spontaneous preterm premature rupture of membranes (PROM) and placental abruption (PA) cases are conflicting. We modeled the time of onset of preterm PROM and PA cases and examined if the circadian profiles varied based on the gestational age at delivery. Methods We used parametric and nonparametric methods, including trigonometric regression in the framework of generalized linear models, to test the presence of circadian rhythms in the time of onset of preterm PROM and PA cases, among 395 women who delivered a singleton between 2009 and 2010 in Lima, Peru. Results We found a diurnal circadian pattern, with a morning peak at 07h:32’ (95%CI:05h:46’ – 09h:18’) among moderate preterm PROM cases (P-value<0.001), and some evidence of a diurnal circadian periodicity among PA cases in term infants (P-value=0.067). However, we did not find evidence of circadian rhythms in the time of onset of extremely or very preterm PROM (P-value=0.259) and preterm PA (P-value=0.224). Conclusions The circadian rhythms of the time of onset of preterm PROM and PA cases varied based on gestational weeks at delivery. While circadian rhythms were presented among moderate preterm PROM and term PA cases, there was no evidence of circadian rhythms among preterm PA and very or extremely preterm PROM cases, underlying other mechanisms associated with the time of onset. PMID:25453346

  10. Evaluation of perinatal outcomes in pregnant women with preterm premature rupture of membranes

    Directory of Open Access Journals (Sweden)

    Alex Sandro Rolland Souza

    2016-06-01

    Full Text Available SUMMARY Objective: To determine the association between amniotic fluid index (AFI and perinatal outcomes in preterm premature rupture of membranes (PPROM. Method: A retrospective cohort study was conducted between 2008 and 2012. 86 pregnant women were included, with a diagnosis of PPROM and gestational age from 24 to 35 weeks. Women who presented hypertensive disorders, diabetes, fetuses with birth defects and infection at admission were excluded. To determine the association between AFI and perinatal outcomes, chi-square and Fisher’s exact test were used if necessary, as well as risk ratio (RR and 95% confidence intervals (95CI. Correlation between AFI and perinatal outcomes was determined by using simple linear regression, and AFI progression during pregnancy was analyzed by Z-test. Results: When comparing newborns presenting ultrasound with AFI5cm, there was a higher frequency of perinatal mortality when the AFI was lower than 5 cm. However, when the oligohydramnios was diagnosed as severe (AFI3cm. There was a positive correlation between AFI and gestational age at delivery, birth weight and Apgar scores at minutes 1 and 5. There was also a decrease in amniotic fluid volume with increased gestational age. Conclusion: The presence of severe oligohydramnios after PPROM contributed to a higher frequency of perinatal complications and death.

  11. Fetal MRI for prediction of neonatal mortality following preterm premature rupture of the fetal membranes.

    Science.gov (United States)

    Messerschmidt, Agnes; Pataraia, Anna; Helmer, Hanns; Kasprian, Gregor; Sauer, Alexandra; Brugger, Peter C; Pollak, Arnold; Weber, Michael; Prayer, Daniela

    2011-11-01

    Lung MRI volumetrics may be valuable for fetal assessment following early preterm premature rupture of the foetal membranes (pPROM). To evaluate the predictive value of MRI lung volumetrics after pPROM. Retrospective cohort study of 40 fetuses after pPROM in a large, tertiary, perinatal referral center. Fetuses underwent MRI lung volumetrics. Estimated lung volume was expressed as percentage of expected lung volume (our own normal references). Primary outcome was neonatal mortality due to respiratory distress before discharge from hospital. Gestational age range was 16-27 weeks. Estimated-to-expected lung volume was 73% in non-survivors and 102% in survivors (P < 0.05). There were no survivors with a lung volume less than 60% of expected. By logistic regression, mortality could be predicted with a sensitivity of 80%, specificity of 86% and accuracy of 85%. Fetal MR lung volumetrics may be useful for predicting mortality due to respiratory distress in children with early gestational pPROM.

  12. [Usefulness of the flame test in the diagnosis of premature rupture of fetal membranes].

    Science.gov (United States)

    Oliveros Ceballos, A; Ahued Ahued, J R; Violante Díaz, M; de la Jara Díaz, J

    1989-07-01

    A prospective, experimental and comparative study, was carried out at the Labor Service and Perinatology Service at Gyn-Ob Division, Regional Hospital "20 de Novembre" ISSSTE, Mexico City, during the period from September 1st, 1987 to September 1st., 1988. The objective was to demonstrate usefulness of the Flame Test in the diagnosis of premature rupture of membranes (PRM). A total of 116 samples from patients randomly selected, in four groups (3 controls and one problem group), were studied. The test was used in comparison with crystallography. Age, gesta, parity, abortion and cesarean section, and birth's via, as well as the antecedent of use of anticonceptives, were studied. Twenty six samples in Group I, 10 in Group II, 40 in Group III and 40 in Group IV, were obtained. The statistical method of X,2 was used, and a statistically significant difference (p.05), was obtained, with a sensitivity of 97.8%, and specificity of 100%, a predictive value of 100%, and security of 98% for the test. It's concluded that the Flame test is useful in the diagnosis of PRM, with a low cost, a high sensitivity, and a similar specificity to the reported one by others.

  13. Fetal MRI for prediction of neonatal mortality following preterm premature rupture of the fetal membranes

    Energy Technology Data Exchange (ETDEWEB)

    Messerschmidt, Agnes; Sauer, Alexandra; Pollak, Arnold [Medical University of Vienna, Department of Pediatrics and Adolescent Medicine, Vienna (Austria); Pataraia, Anna; Kasprian, Gregor; Weber, Michael; Prayer, Daniela [Medical University of Vienna, Department of Radiology, Vienna (Austria); Helmer, Hanns [Medical University of Vienna, Department of Obstetrics and Maternal-Fetal Medicine, Vienna (Austria); Brugger, Peter C. [Medical University of Vienna, Center of Anatomy and Cell Biology, Vienna (Austria)

    2011-11-15

    Lung MRI volumetrics may be valuable for fetal assessment following early preterm premature rupture of the foetal membranes (pPROM). To evaluate the predictive value of MRI lung volumetrics after pPROM. Retrospective cohort study of 40 fetuses after pPROM in a large, tertiary, perinatal referral center. Fetuses underwent MRI lung volumetrics. Estimated lung volume was expressed as percentage of expected lung volume (our own normal references). Primary outcome was neonatal mortality due to respiratory distress before discharge from hospital. Gestational age range was 16-27 weeks. Estimated-to-expected lung volume was 73% in non-survivors and 102% in survivors (P < 0.05). There were no survivors with a lung volume less than 60% of expected. By logistic regression, mortality could be predicted with a sensitivity of 80%, specificity of 86% and accuracy of 85%. Fetal MR lung volumetrics may be useful for predicting mortality due to respiratory distress in children with early gestational pPROM. (orig.)

  14. The comparison of amnisure ™ and altest ™ in the detection of the premature rupture of membranes

    OpenAIRE

    YILDIRIM, Gazi; Attar, Rukset; FIÇICIOĞLU, Cem; Karateke, Ateş; YEŞİLDAĞLAR, Narter

    2009-01-01

    Objectives: Amnisure™ (based on the existense of PAMG-1 in vaginal fluid) and Altest™ (based on the nitrasin test) were compared to detect a reliable, sensitive and quick test for the detection of the premature rupture of membranes in pregnancy. Material and Methods: Fifty pregnant patients between 21-38 weeks who has a suspicion for the fluid leakage were enrolled to the study. Altest™ and then Amnisure™ were applied. A sterile speculum examination and pooling were ev...

  15. Frequency and clinical significance of short cervix in patients with preterm premature rupture of membranes

    Science.gov (United States)

    Lee, Seung Mi; Park, Kyo Hoon; Jung, Eun Young; Jang, Ji Ae; Yoo, Ha-Na

    2017-01-01

    Objective Cervical length measurement has been uggested as a useful tool for predicting intra-amniotic infection/inflammation in preterm labor, but little information is available in the setting of preterm premature rupture of membranes (pPROM). We aimed to determine whether a short cervical length is independently associated with an increased risk of intra-amniotic infection or inflammation and impending preterm delivery in women with pPROM. Methods This was a retrospective cohort study involving 171 consecutive singleton pregnant women with pPROM (21+0–33+6 weeks’ gestation), who underwent amniocentesis. Amniotic fluid (AF) was cultured, and assayed for interleukin (IL)-6 and IL-8. Cervical length was measured at the time of amniocentesis by transvaginal ultrasonography with an aseptic technique. Short cervical length was defined as a cervical length of ≤15 mm. Intra-amniotic infection was defined as a positive AF culture for microorganisms and intra-amniotic inflammation was defined as elevated AF concentrations of IL-6 or IL-8 (IL-6 ≥1.5 ng/mL and/or IL-8 ≥1.3 ng/mL). Results Fifty (29.2%) women had a sonographic cervical length of ≤15mm. On univariate analysis, short cervical length was associated with an increased risk for intra-amniotic infection and/or inflammation; no other parameters studied showed a significant association. Multivariable analyses indicated that short cervical length was significantly associated with a higher risk of impending preterm delivery (within 2 days of measurement, within 7 days of measurement, and before 34 weeks), and remained significant after adjustment for potential confounders. Conclusion In women with pPROM, short cervical length is associated with an increased risk for intra-amniotic infection/inflammation and associated with impending preterm delivery, independent of the presence of intra-amniotic infection/inflammation. PMID:28358839

  16. The effect of magnesium sulfate administration for neuroprotection on latency in women with preterm premature rupture of membranes

    Science.gov (United States)

    Horton, Amanda L.; Lai, Yinglei; Rouse, Dwight J.; Spong, Catherine Y.; Leveno, Kenneth J.; Varner, Michael W.; Mercer, Brian M.; Iams, Jay D.; Wapner, Ronald J.; Sorokin, Yoram; Thorp, John M.; Ramin, Susan M.; Malone, Fergal D.; O'Sullivan, Mary J.; Hankins, Gary D. V.; Caritis, Steve N.

    2015-01-01

    Objective To evaluate whether magnesium sulfate administration for neuroprotection prolongs latency in women with preterm premature rupture of membranes between 24 and 31 6/7 weeks' gestation. Study Design This is a secondary analysis of a randomized controlled trial of magnesium sulfate for prevention of cerebral palsy. Gravid women with a singleton pregnancy between 24 and 31 6/7 weeks' gestation with preterm premature rupture of membranes (pPROM) without evidence of labor were randomized to receive magnesium sulfate, administered intravenously as a 6-g bolus followed by a constant infusion of 2 g per hour up to 12 hours, or placebo. Maternal outcomes for this analysis were delivery in less than 48 hours and in less than 7 days from randomization. Neonatal outcomes included a composite of respiratory distress, interventricular hemorrhage grades 3 or 4, periventricular leukomalacia, sepsis, necrotizing enterocolitis, retinopathy of prematurity, or death. Results A total of 1259 women were included. The rate of delivery < 48 hours was not different in the magnesium sulfate and the placebo groups (22.2% and 20.7%, p=0.51). Delivery < 7 days was similar between groups (55.4% and 51.4%, p=0.16). Median latency was also similar between groups (median [interquartile range] 6.0 days [2.4–13.8] and 6.6 days [2.4–15.1], p =0.29). Composite neonatal outcomes did not differ between groups. Conclusion: Magnesium sulfate administration given for neuroprotection in women with a singleton gestation with preterm premature rupture of membranes and without labor before 32 weeks does not impact latency. PMID:25241107

  17. Comparative Study of Pregnancy Outcome in Premature Rupture of Membranes With Amniotic Fluid Indices of less and more than 5

    Directory of Open Access Journals (Sweden)

    F Tavassoli

    2010-03-01

    Full Text Available Introduction: Preterm premature rupture of the membranes (PPROM is one of the most important causes of perinatal morbidity and mortality. The aim of this study was to evaluate pregnancy outcome in preterm premature rupture of the membranes with amniotic fluid index less than 5 and more than 5. Methods: This prospective study was performed on 137 pregnant women with gestational age of 28-34 weeks with PPROM from Oct 2006 to Oct 2008. The patients were divided in two groups according to amniotic fluid index: AFI<5 (77 cases, AFI≥5 (60 cases. Chi-square test was used for qualitative variables, while T-student test was used for quantitative test. Results: Both groups were similar with respect to number of pregnancies, gestational age at rupture of the membranes and birth weight. In the group with AFI<5, applied latency was significantly shorter (PV=0.049, rate of cesarean section was higher due to fetal distress (PV=0.008, neonatal Apgar score in first minute was lower during the first week (PV=0.0127 and the rate of neonatal death was higher (PV=0.045 during the first week. Conclusion: An AFI<5 cm after PPROM is associated with earlier delivery, higher rate of cesarean due to fetal distress, higher rate of neonatal death, and lower neonatal Apgar score in first minute during the first week

  18. High proportions of obstetric referrals in Addis Ababa: the case of term premature rupture of membranes.

    Science.gov (United States)

    Mirkuzie, Alemnesh H; Sisay, Mitike Molla; Bedane, Mulu Muleta

    2016-01-25

    The Public Health Centers (HCs) provide basic obstetric and neonatal care to about 80% of the eligible population in Addis Ababa. Hospitals provide comprehensive services and are referral centers for complications that cannot be managed at the HCs. This study assessed the proportion of obstetric referrals in general and referrals due to premature rupture of membranes (PROM) at term in particular, from the HCs in Addis Ababa and explored its appropriateness and management in hospitals. The study used a sequential explanatory mixed methods design. Routine retrospective data were collected from ten randomly selected HCs in 2012. Key informant interviews were conducted using a guide developed following a preliminary analysis of the quantitative data. Ten head midwives, one from each health center participated in the interviews. Of the 9340 mothers who sought skilled birth care in the ten HCs in 2012, 2820 (30.3%) were diagnosed with obstetric complications and referred to hospital. Term PROM accounted for 557 (19.7%) of the referrals and it was widely varied across the HCs. Fifteen (7.8%) mothers who were referred for PROM, had intact membranes upon hospital examinations. Forty-two (77.8%) of the referred mothers who had spontaneous labour and delivery could have been misclassified as not having labour upon referral. In the interviews, variations in diagnosing and managing term PROM were identified as themes. Three HCs relayed solely on mothers' self reports of amniotic fluid leakage to diagnose, two HCs did complementary speculum/vaginal examination, three HCs monitored sign of labour on top of confirming the leakage. Regarding management, two HCs practiced expectant management, three referred mothers after 30 min of observation while others issued referral right away. All providers reported the lack of clinical guidelines for most common obstetric problems in their HC. The study reported large proportion of obstetric referrals in general and PROM referrals in

  19. Amenaza de parto prematuro: Rotura prematura de membranas. Corioamnionitis Preterm labour: Premature rupture of membranes. Chorioamnionitis

    Directory of Open Access Journals (Sweden)

    A. Ochoa

    2009-01-01

    patients. They include antecedents of preterm labour, signs and symptoms, cervical alteration, etc. Premature rupture of membranes and chorioamnionitis involve the risk of preterm labour if they occur in early gestational ages.

  20. Observation and Clinical Care of Premature rupture of membranes%胎膜早破的观察与临床护理

    Institute of Scientific and Technical Information of China (English)

    刘锦梅

    2014-01-01

    目的:回顾2010年6月~2013年6月我院收治123例胎膜早破病例,总结胎膜早破的护理措施。方法对123例胎膜早破病例进行分析。结果123例中发生新生儿死亡1例。结论正确处理胎膜早破,做好胎膜早破的护理,特别是心理护理,积极预防并发症,减少围生儿死亡率。%Objective: back in 2010 June -2013 year in June the hospital treated 123 cases of premature rupture of membrane case, summarize the nursing measures of premature rupture of membranes. Methods: 123 cases of premature rupture of membranes were analyzed. Results in the 123 cases, 1 cases of neonatal death. Conclusion: the correct treatment of premature rupture of membrane, the nursing of premature rupture of membranes, especial y the psychological nursing, prevention of complications, reduce perinatal mortality.

  1. Neonatology oxidative status in preterm infants with premature preterm rupture of membranes and fetal inflammatuar response syndrome.

    Science.gov (United States)

    Özalkaya, Elif; Karatekin, Güner; Topçuoğlu, Sevilay; Karatepe, Hande Özgün; Hafızoğlu, Taner; Baran, Pervin; Ovalı, Fahri

    2017-10-01

    The aim of this study, to determine an index of oxidative stress index in preterm infants less than 34 weeks gestational age with premature preterm rupture of membrane (PPROM) and fetal inflammatory response syndrome (FIRS). This study was designed as a prospective study. Fifty-one premature infants less than 35 weeks of gestational age were included in the study. The umbilical cord blood concentrations of IL-6, TAC (total antioxidant capacity) and PON-1 (paraoxonase-1) levels and TOS (total oxidative stress) were studied. The oxidative stress index (OSI = TAC/TOS) was calculated in all of prematüre infants. PPROM was defined as rupture of membranes at least 24 hours before the onset of labor. FIRS was defined by an umbilical cord IL-6 level greater than 11 pg/mL. Premature infants included in the study were divided into 4 groups. Group 1 included preterm infants without FIRS and with PPROM (n = 16), while Group 2 included preterm infants without PPROM and with FIRS (n = 9), Group 3 consisted of premature infants with PPROM and FIRS (n = 21) and Group 4 included premature infants without PPROM or FIRS (n = 5). Umbilical cord TOS level was found to be higher in the preterm infants without FIRS and with PPROM (36.1 μmol H2O2 Equiv./L) compared to the preterm infants without PPROM or FIRS (11.9 μmol H2O2 Equiv./L) (p = 0.03). Umbilical cord PON-1 level was found to be lower in the preterms without FIRS and with PPROM (32 U/L), preterms without PPROM and with FIRS (30. 3 U/L) and the preterm infants with both PPROM and FIRS (48.6 U/L) compared to the preterm infants having no PPROM or FIRS (85.6 U/L) (p = 0.001). High pro-oxidant capacity was found in PPROM and low antioxidant capacity in PPROM and FIRS. Copyright © 2017. Published by Elsevier B.V.

  2. Preterm premature rupture of membranes and the rate of neonatal sepsis after two courses of antenatal corticosteroids.

    Science.gov (United States)

    Gyamfi-Bannerman, Cynthia; Son, Moeun

    2014-11-01

    To evaluate whether a second antenatal corticosteroid course is associated with an increased risk of neonatal sepsis after preterm premature rupture of membranes (PROM). This secondary analysis is a cohort study with data from the Maternal-Fetal Medicine Units study on magnesium for neuroprotection. Women with singleton gestations and preterm PROM were eligible. The primary exposure was one compared with two antenatal corticosteroid courses. The primary outcome, neonatal sepsis, was compared between exposed groups. Patient characteristics were analyzed by χ2 for categorical variables and Student t test or Wilcoxon rank-sum for continuous variables where appropriate. Predictors of neonatal sepsis were analyzed by multivariable logistic regression. One thousand six hundred forty-one patients were eligible. Neonatal sepsis was similar among neonates born to mothers who received one or two antenatal corticosteroid courses (16.2% compared with 17.2%, P=.756, respectively). Adjusting for confounders, the factors associated with neonatal sepsis were length of time from membrane rupture to delivery (odds ratio [OR] 1.52, 95% confidence interval [CI] 1.02-2.26), respiratory distress syndrome (OR 2.11, 95% CI 1.45-3.07), gestational age at delivery in days (OR 0.98, 95% CI 0.95-0.99) and birth weight per 100 g (OR 0.85, 95% CI 0.77-0.94). A second maternal antenatal corticosteroid course was not associated with an increased rate neonatal sepsis.

  3. Experience of nursing care of pregnant woman with premature rupture of membranes%胎膜早破孕妇的护理体会

    Institute of Scientific and Technical Information of China (English)

    毛秀琴

    2015-01-01

    Objective:To investigate the cause of premature rupture of membranes,to take effective nursing measures to reduce its harm.Methods:36 cases of pregnant women with premature rupture of membranes were selected.They were given effective treatment and nursing.We observed the effect.Results:Taking effective nursing measures for pregnant woman with premature rupture of membranes at duration of pregnancy could obtain satisfactory clinical effects.Conclusion:The correct treatment for pregnant woman with premature rupture of membranes,good nuring for premature rupture of membranes and active prevention of complications can reduce maternal puerperal infection and neonatal mortality rate.%目的:探讨胎膜早破的原因,采取有效的护理措施减少对母婴的危害。方法:收治胎膜早破孕妇36例,实施有效的治疗和护理,观察效果。结果:对妊娠期胎膜早破不同孕周的孕妇采取合理有效的护理措施可取得满意的临床效果。结论:正确处理胎膜早破的孕妇,做好胎膜早破的护理,积极预防并发症发生,可减少孕妇产褥感染率及新生儿病死率。

  4. Study on the risk factors of premature rupture of membranes%胎膜早破的危险因素分析

    Institute of Scientific and Technical Information of China (English)

    李智泉; 王晨虹

    2010-01-01

    Objective To investigate the risk factors of incidence of premature rupture of membranes and provide reference for prevention of premature rupture of membranes.Methods 890 cases of infants and maternal were studied,analyzing and screening the risk factors of premature rupture of membranes by Logistic.Results The single-factor analysis showed that the pregnant women with diabetes,pregnancy-induced hypertension,multiple preg-nancy and vaginifis had certain degree of contact with incidence of premature rupture of membranes.Multivariate Lo-gistic regression analysis showed that the multiple pregnancy and vaginitis were risk factors of incidence of premature rupture of membranes.Conclusion The multiple pregnancy and vaginitis were risk factors of incidence of premature rapture of membranes,assessment and control these risk factors could prevent and reduce the incidence of premature rupture of membranes.%目的 探讨胎膜早破发生的危险因素,为胎膜早破的防治提供理论参考.方法 对890例新生儿及产妇的临床资料进行回顾性分析,对胎膜早破发生的相关危险因索进行Logistic回归分析,筛选胎膜早破发生的相关危险因素.结果 单因素分析结果显示,妊娠合并糖尿病、妊娠期高血压疾病、多次妊娠、阴道炎与胎膜早破发生有关;多因素Logistic回归分析表明,多次妊娠和阴道炎是胎膜早破发生的危险因素.结论 多次妊娠和阴道炎是胎膜早破发生的重要危险因素,对这些危险因素加以重点评估和合理控制,可以预防和降低胎膜早破的发生.

  5. Perfil Biofísico Fetal na Ruptura Prematura das Membranas Fetal Biophysical Profile in Premature Rupture of the Membranes

    Directory of Open Access Journals (Sweden)

    Vardeli Alves de Moraes

    2000-05-01

    modifications due to premature rupture of the membranes of variables of the fetal biophysical profile, comparing them to the ones found in pregnant women with intact membranes. In the group with premature rupture of the membranes, the association of biophysical variables with the Apgar score at the first and fifth minutes and with the occurrence or not of clinical chorioamnionitis and neonatal infection was analyzed. Patients and Methods: in a prospective study, 112 fetal biophysical profiles were established in 60 pregnant women with premature rupture of the membranes at a period between the 28th and the 40th week of pregnancy, and only the last fetal biophysical profile was analyzed and compared to other 60 fetal biophysical profiles of pregnant women with gestational ages identical to the group of study and with intact membranes. Results: statistical analysis of the results revealed that the premature rupture of the membranes diminished the reactivity, not interfering with the body movements of the fetus. It also diminished the frequency of the respiratory movements of the fetus, not determining modifications of the fetal tonus, and considerably decreasing the amniotic fluid index. In terms of prediction of chorioamnionitis and neonatal infection, the fetal biophysical profile did not show any significant statistic validity; however, when the biophysical variables were present, the correlation with the absence of chorioamnionitis and neonatal infection was clearly shown. The result of the last fetal biophysical profile was strongly associated with the Apgar score at the 5th minute. Conclusion: the fetal biophysical profile should be used routinely in pregnant women with premature rupture of the membranes with the purpose of evaluating fetal vitality, and in order to detect those fetuses at a higher risk of infection, specially those with gestational ages of less than 34 weeks. Regarding those fetuses it is best to use a conservative approach.

  6. 未足月妊娠胎膜早破并发早产108例临床分析%Clinical Analysis of 108 Cases with Preterm Premature Rupture of Mem-brane Complicated by Premature Delivery

    Institute of Scientific and Technical Information of China (English)

    程宝珠

    2016-01-01

    Objective To study the relevant treatment method and application effect of preterm premature rupture of mem-brane complicated by premature delivery. (Pregnant week was between 28 weeks to 34 weeks). Methods The clinical data of 108 cases of patients with preterm premature rupture of membrane complicated by premature delivery admitted and treated in out-patient department of our hospital were retrospectively analyzed, and the pathogenic factors of premature rupture of membranes, delivery method and general conditions of perinatal infants were analyzed. Results Vaginitis was a very com-mon cause of premature rupture of membranes, the incubation period of premature rupture of membranes was 2h-16d, (6.2± 1.3)d on average;and the difference in the A p-g a r score of perinatal infants between two delivery methods had no statis-tical significance by comparison (P>0.05); the differences in the incidence rate of complications of perinatal infants and death rate between the pregnant women whose pregnant weeks were between 28 weeks and 30 weeks and the pregnant women whose pregnant weeks were between 31 weeks and 34 weeks had statistical significance by comparison, (all P0.05);针对孕周处于28周与30周的孕产妇和孕周处于31周与34周的孕产妇,这两组围产儿并发症的发生率和死亡率相比,比较差异有统计学的意义(由于P<0.05)。结论要及时地借助于期待疗法对未足月妊娠胎膜早破并发早产患者进行治疗,在孕产妇破膜后,医务人员要适时给予其适量的宫缩抑制剂、糖皮质激素和抗生素等药物,以使孕产妇的潜伏期能够有效延长到孕30周以上,从而可以有效地降低早产儿的死亡率。

  7. Soluble and Endogenous Secretory Receptors for Advanced Glycation End Products in Threatened Preterm Labor and Preterm Premature Rupture of Fetal Membranes

    Directory of Open Access Journals (Sweden)

    Rafał Rzepka

    2015-01-01

    Full Text Available The aim of the study was to compare sRAGE and esRAGE plasma levels in pregnant women with (A threatened premature labor (n=41, (B preterm premature rupture of membranes (n=49, and (C preterm rupture of membranes at term (n=48. The relationship between these and classic intrauterine infection markers and the latent time from symptoms up to delivery depending on RAGE’s concentration were investigated. In groups A and B, a positive correlation was found between plasma sRAGE and latent time (r = 0,422; p = 0,001; r = 0,413, p = 0,004, resp.. High prognostic values were found in both groups for plasma sRAGE concentration and the latent time from symptoms up to delivery. Groups B and C presented higher levels of esRAGE than group A (526,315 ± 129,453 pg/mL and 576,212 ± 136,237 pg/mL versus 485,918 ± 133,127 pg/mL, p< 0,05. The conclusion is that sRAGE concentration can be a favorable prognostic factor in the presence of symptoms of threatened premature labor. Higher esRAGE plasma level in case of the rupture of membranes in mature and premature pregnancy suggests its participation in fetal membranes destruction.

  8. Clinical significance of histologic chorioamnionitis with a negative amniotic fluid culture in patients with preterm labor and premature membrane rupture

    Science.gov (United States)

    Park, Jeong Woo; Park, Kyo Hoon; Jung, Eun Young

    2017-01-01

    Objective To evaluate the effect of histological chorioamnionitis (HCA) with a negative amniotic fluid (AF) culture on adverse pregnancy and neonatal outcomes and inflammatory status in the AF compartment in women with preterm labor or preterm premature rupture of membranes (PPROM). Methods This is a retrospective cohort study of 153 women diagnosed as having a preterm labor or PPROM (20–34 weeks) who delivered singleton gestations within 48 hours of amniocentesis. AF obtained through amniocentesis was cultured, and interleukin (IL)-6, IL-8, and metalloproteinase-9 (MMP-9) levels were determined. The placentas were examined histologically. Results The prevalence of HCA with negative AF culture was 23.5% (36/153). The women with HCA but with a negative AF culture (group 2) and those with a positive AF culture (group 3) had a significantly lower mean gestational age at amniocentesis and delivery than those with a negative AF culture and without HCA (group 1). Women in group 3 had the highest levels of AF IL-6, IL-8, and MMP-9, followed by those in group 2, and those in group 1. Composite neonatal morbidity was significantly higher in groups 2 and 3 than in group 1, but this was no longer significant after adjusting for confounders caused mainly by the impact of gestational age. Discussion In the women who delivered preterm neonates, HCA with a negative AF culture was associated with increased risks of preterm birth, intense intra-amniotic inflammatory response, and prematurity-associated composite neonatal morbidity, and its risks are similar to the risk posed by positive AF culture. PMID:28278303

  9. ROLE OF ALPHA FETO PROTIEN AS A MARKER IN DIAGNOSIS OF PREMATURE RUPTURE OF MEMBRANES IN RURAL POPULATION

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    Pahula

    2015-08-01

    Full Text Available AIM : In India, especially in rural population multiple factors adversely affect the incidence of premature rupture of membrane. The purpose of this study is to test the amniotic fluid Alpha feto protein as a reliable mar ker for the detection of PPROM and to test its efficacy for the purpose in the rural India. STUDY DESIGN : This study was conducted in the Department of Obstetrics & Gynecology, NIMS Medical College & Hospital, Jaipur, Rajasthan. This was a cross sectional study during period of one year with sample size of 100 patients . METHOD S : Patients who were at ≥24 weeks of gestation with the complains of leaking per vaginum. Sample for Alpha - fetoprotein (AFP estimation was collected by instilling 5 ml of distilled wa ter into vagina, irrespective of pooling of amniotic fluid and sent to the biochemistry lab for the analysis and for the estimation of alpha fetoprotein by using Electroluminescence enzyme immunoassay method. RESULT: The sensitivity, specificity, positive predictive value and negative predictive value are 92%, 98%, 92% and 98% respectively. CONCLUSION: The AFP can be used as reliable marker to avoid unnecessary obstretic interventions for diagnosis of PROM.

  10. Induction versus expectant management in premature rupture of the membranes with mature amniotic fluid at 32 to 36 weeks: a randomized trial.

    Science.gov (United States)

    Mercer, B M; Crocker, L G; Boe, N M; Sibai, B M

    1993-10-01

    Our objective was to compare maternal and perinatal outcomes between two management schemes for women with preterm premature rupture of the membranes and documented fetal pulmonary maturity. Of 164 women with preterm premature rupture of the membranes at 32 weeks to 36 weeks 6 days' gestation, 93 eligible and consenting women were randomly selected for either induction of labor (n = 46) or expectant management (n = 47). Expectant management included hospitalization, assessment for fetal heart rate abnormalities, chorioamnionitis, and labor. Digital cervical examinations were prohibited until progressive labor occurred. Follow-up was also done for the 71 women who did not participate. The women in the induction of labor and expectant management groups had similar demographic characteristics and gestational ages (34.1 vs 34.3 weeks). Expectant management was associated with prolonged latencies to labor, delivery, and maternal hospitalization (p mature surfactant profiles, immediate induction of labor reduces the duration of hospitalization and infection in both mothers and neonates.

  11. STUDY OF CLINICAL: DEMOGRAPHIC PROFILE, MANAGEMENT & FOETAL OUTCOME AMONG PREGNANT WOMEN WITH PREMATURE RUPTURE OF MEMBRANE ATTENDING THE TERTARY CARE CENTRE, MAHARAHSTRA

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    Chetan A

    2014-10-01

    Full Text Available BACKGROUND: The Premature Rupture of Membrane (PROM is one of the key factors in maternal and foetal prognosis. The management of premature rupture of membrane varies according to gestational age, duration of latent period, maternal and foetal well-being, and experienced obstetrician. The objective was to study the profile, management and foetal outcome among PROM cases. METHODOLOGY: The present study carried out at tertiary care Centre over the period of 6 months. PROM cases were included for study. Management of PROM cases was done as per institutional protocol. Duration of PROM, Vaginal swab, Mode of delivery, Birth weight, CBC & blood culture of newborn etc. collected from the records. All data collected and analyzed statistically. RESULTS: Total 100 cases were included. 56 % & 36 % pregnancies were multigravida and Preterm respectively. Leucorrhoea, fever, burning micturition were suspected risk factors among PROM cases. 97% of PROM with preterm pregnancy had spontaneous onset of labour. 100% went into spontaneous labour when cervical dilatation on admission was more than 3cm. 63.8% of Preterm with PROM cases went into spontaneous labour within 24 hrs. 59.3% of vaginal swab positive pregnant mothers had newborn with the sepsis. Poor APGAR score was 71.5% were from preterm PROM cases. low birth weight was observed among 49(48% neonates, out of which 25(71.4% were from preterm PROM cases. 30 (29.4% cases having neonatal sepsis clinically, out of which 60% were full term PROM cases. 7 (6.8% death occurred among the neonates, out of which 04(57.2% were preterm PROM cases. CONCLUSION: The study concludes that the management of preterm PROM cases is very crucial. Neonatal out come in cases of premature rupture of membranes was mainly related to gestation age, total duration of premature rupture of membrane and mode of delivery.

  12. Meta-analysis of studies on biochemical marker tests for the diagnosis of premature rupture of membranes: comparison of performance indexes

    OpenAIRE

    Palacio, Montse; Kühnert, Maritta; Berger, Richard; Larios, Cindy L; Marcellin, Louis

    2014-01-01

    Background Premature rupture of the membranes (PROM) is most commonly diagnosed using physical examination; however, accurate decision making in ambiguous cases is a major challenge in current obstetric practice. As this may influence a woman’s subsequent management, a number of tests designed to assist with confirming a diagnosis of PROM are commercially available. This study sought to evaluate the published data for the accuracy of two amniotic fluid-specific biomarker tests for PROM: insul...

  13. Observation and nursing experience of premature rupture of membranes%胎膜早破的观察及护理体会

    Institute of Scientific and Technical Information of China (English)

    明淑芹

    2014-01-01

    Premature rupture of membranes is a common complication of obstetric.The causes include genital tract inflammation, malposition, unreasonable nutrition, sex, etc.Premature rupture of membranes are adversely affected on pregnancy and childbirth. Close observation and nursing care for patients with premature rupture of membranes, at the same time strengthen the antenatal care and prenatal health knowledge, can reduce complications,and reduce maternal puerperal infection rate and neonatal mortality.%胎膜早破是产科常见的并发症,发生的原因包括生殖道炎症、胎位不正、营养不合理、性生活等。胎膜早破对妊娠和分娩均造成不利影响。通过对胎膜早破患者进行严密的观察和护理,同时加强产前保健和孕期卫生知识,可减少并发症的发生,减少孕妇产褥感染率及新生儿病死率。

  14. 183例胎膜早破临床特征分析%Analysis on Clinical Features of 183 Patients with Premature Rupture of Membrane

    Institute of Scientific and Technical Information of China (English)

    马丽灵

    2011-01-01

    [目的]探讨胎膜早破发生的高危因素、分娩方式与母婴并发症的关系及处理、预防方法.[方法]回顾性分析2008年1月至2010年12月在本院住院分娩的183例胎膜早破孕妇,另随机抽取本院同期无胎膜早破的孕妇183例作为对照组,比较两组的分娩方式及母婴并发症,分析胎膜早破的高危因素.[结果]胎膜早破的高危因素主要是头盆不称、阴道炎、流产引产史、胎位异常.观察组的剖宫产率(56.83%) 明显高于对照组(40.98%)(P<0.01);观察组发生产后出血(P<0.01)、早产、胎儿窘迫、新生儿窒息、新生儿肺炎、死胎、早期新生儿死亡的发病率明显高于对照组(P<0.05),但两组发生产褥感染的比例差异无统计学意义(P>0.05).[结论]胎膜早破的剖宫产率、产后出血、胎儿窘迫、新生儿窒息、新生儿肺炎、死胎、早期新生儿死亡的发生率升高,应重视胎膜早破的高危因素及处理,适时终止妊娠,减少难产及母婴并发症的发生.%[Objective]To explore the high risk factors, delivery way of premature rupture of membrane and its relationship with maternal and neonatal complications and their management and prevention methods.[Methods] Totally 183 pregnant women with premature rupture of membrane from Jan. 2008 to Dec. 2010 in our hospital were analyzed retrospectively. Moreover, 183 pregnant women without premature rupture of membrane were randomly chosen as control group. The delivery way and maternal and neonatal complications were compared between two groups. The high risk factors of premature rupture of membrane were analyzed.[Results]The high risk factors of premature rupture of membrane were mainly cephalopelvic disproportion,vaginitis, the history of abortion and induced labor and abnormal fetal position. The rate of caesarean section in observation group(56. 83 %) was significantly higher than that that in control group(40.98 %)( P <0.01).The incidence

  15. Rupture

    CERN Multimedia

    Association du personnel

    2006-01-01

    Our Director-General is indifferent to the tradition of concertation foreseen in our statutes and is "culturally" unable to associate the Staff Association with problem-solving in staff matters. He drags his heels as long as possible before entering into negotiations, presents "often misleading" solutions at the last minute which he only accepts to change once a power struggle has been established. Faced with this rupture and despite its commitment to concertation between gentlemen. The results of the poll in which the staff is invited to participate this week. We therefore need your support to state our claims to the Governing Bodies. The Staff Association proposes a new medium of communication and thus hopes to show that it is ready for future negotiations. The pages devoted to the Staff Association are presented in a more informative, reactive and factual manner and in line with the evolution of the social situation at CERN. We want to establish strong and continuous ties between the members of CERN and ou...

  16. Pregnancy Outcomes Complicated by Preterm Premature Rupture of Membranes: Retrospective Review of Cases in Three Institutions in Kazakhstan

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    Balkenzhe Imankulova

    2015-06-01

    Full Text Available Introduction. Pre-term premature rupture of membranes (PPROM is one of the leading causes of perinatal morbidity and mortality. This complication is diagnosed in 3% of pregnant women in Kazakhstan, and it is the leading cause of pre-term deliveries. The aim of this study was to determine the outcomes of pregnancies complicated by PPROM in gestation periods between 24 to 32 weeks among three institutions in Kazakhstan.Methods. This is descriptive analysis of 154 cases with PPROM observed between 24 to 32 weeks of gestation at Perinatal Centers #2 and #3 and the National Research Center for Maternal and Child Health, Astana, Kazakhstan. Cases were selected on the basis of retrospective chart review where PPROM diagnosis occurred in 2013. Descriptive statistics were utilized for data analysis.Results. The most frequent complications associated with PPROM were threat of miscarriage (13.6% of cases and chronic placental insufficiency (7.8%. The mean time between PPROM and onset of spontaneous labor was 12.1 ± 2.3 days.  Spontaneous labor within 3 days after PPROM started in patients with an amniotic fluid index of 3.0 ± 0.2 cm. Complications experienced by PPROM women during delivery and early postpartum period included: precipitous labor (6.4%, weakness of labor activity (16.2%, atonic hemorrhage (1.2%, and chorioamnionitis (3.2%. 37.6% of newborns in this study were admitted to the Intensive Care Unit. Their health complications included pneumonia (7.7%, conjunctivitis (1.3%, omphalitis and infectious-toxic shock (3.8%, intraventricular hemorrhage  (7.8%, and respiratory distress (10.3% .Conclusion. Thus, preterm rupture of membranes is associated with preterm delivery and an increase of neonatal morbidity. Therefore, it is necessary to find ways to effectively manage PPROM, including developing new techniques to restore the amniotic fluid volume in women experiencing PPROM during 24 to 32 weeks of gestation. 

  17. Can neonatal sepsis be predicted in late preterm premature rupture of membranes? Development of a prediction model.

    Science.gov (United States)

    van der Ham, David P; van Kuijk, Sander; Opmeer, Brent C; Willekes, Christine; van Beek, Johannes J; Mulder, Antonius L M; van Loon, Aren J; Groenewout, Martiët; Mantel, Gerald D; Bloemenkamp, Kitty W M; Porath, Martina; Kwee, Anneke; Akerboom, Bettina M C; Papatsonis, Dimitri N M; Metz, Godfried C H; Nijhuis, Jan G; Mol, Ben W J

    2014-05-01

    Women with late preterm premature rupture of membranes (PROM) have an increased risk that their child will develop neonatal sepsis. We evaluated whether neonatal sepsis can be predicted from antepartum parameters in these women. We used multivariable logistic regression to develop a prediction model. Data were obtained from two recent randomized controlled trials on induction of labor versus expectant management in late preterm PROM (PPROMEXIL trials, (ISRCTN29313500 and ISRCTN05689407). Data from randomized as well as non-randomized women, who consented to the use of their medical data, were used. We evaluated 13 potential antepartum predictors for neonatal sepsis. Missing data were imputed. Discriminative ability of the model was expressed as the area under the receiver operating characteristic (ROC) curve and a calibration with both a calibration plot and the Hosmer and Lemeshow goodness-of-fit test. Overall performance of the prediction model was quantified as the scaled Brier score. We studied 970 women. Thirty-three (3.4%) neonates suffered neonatal sepsis. Maternal age (OR 1.09 per year), maternal CRP level (OR 1.01 per mmol/l), maternal temperature (OR 1.80 per °C) and positive GBS culture (OR 2.20) were associated with an increased risk of neonatal sepsis. The model had an area under the ROC-curve of 0.71. The model had both a good calibration and accuracy. Antepartum parameters aid in the more precise prediction of the risk of neonatal sepsis in women with late preterm PPROM. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  18. Premature rupture of membranes at 20 weeks: report of a successful outcome after transcervical application of fibrin glue.

    Science.gov (United States)

    Calado, Elsa; Ayres-de-Campos, Diogo

    2007-01-01

    A 30-year-old primigravida was admitted to hospital at 20 weeks of gestation because of premature rupture of membranes and oligohydramnios. The patient was maintained in bed rest and given intravenous ampicillin. Forty-eight hours later, after documenting the absence of infection and maintenance of the oligohydramnios, fibrin glue was applied transcervically under ultrasound control. There was subjective improvement in amniotic fluid volume after treatment, but always within the criteria of oligohydramnios. Fibrin glue application was repeated twice due to reported increase in fluid loss and diminished amniotic fluid volume on ultrasound. Amoxicillin per os was started at 23 weeks, and clavulanic acid was added at 26 weeks due to the isolation of an Escherichia coli on cervical-vaginal cultures. No signs of infection ensued until 34 weeks, when an axillary temperature of 39.5 degrees C was detected together with a non-reassuring cardiotocographic pattern, the latter leading to the performance of an urgent cesarean section. The newborn had an Apgar score of 9/10/10, umbilical artery pH of 7.32, and no external deformities. He showed no signs of lung hypoplasia and required no oxygen supplementation. Oropharyngeal and blood cultures revealed an E. coli infection and antibiotic treatment was started. No further complications occurred and he was discharged home on the 8th day of life. At 12 months, the child reveals a normal development. The mother had a mild and short-lasting wound infection and was discharged on the 8th postoperative day.

  19. Antioxidant Vitamin Status in the Serum and Amniotic Fluid of Women with Premature Rupture of the Fetal Membranes.

    Science.gov (United States)

    Barrett, Bridget M.

    The purpose of this study was to examine the status of antioxidant vitamins in women with premature rupture of the fetal membranes. Specimens of blood and amniotic fluid were obtained from 80 pregnant subjects included both smokers and non-smokers during the third trimester. The concentrations of ascorbic acid (ASA), beta -carotene, retinol and alpha -tocopherol in serum and amniotic fluid were determined. The experimental group consisted of those subjects with PROM while the control subjects were those with normal pregnancy. No statistical differences were found between the PROM and control groups in retinol and vitamin E concentrations in amniotic fluid and serum. Serum ASA concentrations of PROM subjects were not different from controls, but the PROM subjects had significantly lower amniotic fluid ASA concentrations. However, in a study with fewer subjects a lower serum ASA concentration in the PROM subjects was observed. The ratio of amniotic fluid ASA concentration to ASA serum concentration was significantly lower in PROM patients than in controls in both studies. This suggests that low levels of ASA in the amniotic fluid, but not in serum is better associated with PROM. A low amniotic fluid concentration of ASA may reflect an inefficient transfer and/or increased fetal utilization. Alterations in ASA concentration in the amniotic fluid may affect the integrity of the chorioamnion leading to PROM. beta -Carotene was not found in the amniotic fluid. Serum beta-carotene levels were significantly lower in the PROM group compared to the control group. Low concentrations of beta-carotene in maternal serum in smokers not only associated with poor maternal outcome (PROM) but also compromised the fetal outcome (decreased birth weight). Maintenance of adequate serum beta-carotene concentration and amniotic fluid ASA in smokers may result in better maternal and fetal outcome. This study demonstrated that nutrition is an important factor in the prevention of PROM.

  20. Randomized trial of vaginal prostaglandin E2 versus oxytocin for labor induction in term premature rupture of membranes.

    Science.gov (United States)

    Kunt, Cigdem; Kanat-Pektas, Mine; Gungor, Ayse Nur Cakir; Kurt, Raziye Keskin; Ozat, Mustafa; Gulerman, Cavidan; Gungor, Tayfun; Mollamahmutoglu, Leyla

    2010-03-01

    The aim of this study was to compare the efficacy and safety of a prostaglandin E(2) (PGE(2)) vaginal insert with those of oxytocin for labor induction. The present study also examined whether its use reduces the rate of cesarean delivery in term pregnancies with premature rupture of membranes (PROM) and low Bishop scores. A total of 240 women with singleton pregnancies at >or= 37 weeks, no prior uterine scar, vertex presentations, reactive nonstress tests, PROM for >or= 12 hours and Bishop scores of oxytocin or vaginal PGE(2). The primary outcomes were time from induction to delivery and mode of delivery. The time from labor induction to active labor onset was significantly shorter in the oxytocin group than in the PGE(2) group (4.9 +/- 4.1 vs. 8.5 +/- 3.6 hours; p = 0.02). The time from induction to delivery was also significantly shorter in the oxytocin group (3.4 +/- 1.5 vs. 9.6 +/- 4.7 hours; p = 0.02). Cesarean delivery rates were statistically similar in the oxytocin and PGE(2) groups (18.3 vs. 20.0%; p = 0.81). Neonatal outcomes were comparable in both groups. Comparable results were observed for nulliparous women included in the study population. Oxytocin treatment seems to be superior to vaginal administration of PGE(2) to induce labor in term pregnancies complicated with PROM and unfavorable services. (c) 2010 Taiwan Association of Obstetric & Gynecology. Published by Elsevier B.V. All rights reserved.

  1. Mid-trimester preterm premature rupture of membranes (PPROM): etiology, diagnosis, classification, international recommendations of treatment options and outcome.

    Science.gov (United States)

    Tchirikov, Michael; Schlabritz-Loutsevitch, Natalia; Maher, James; Buchmann, Jörg; Naberezhnev, Yuri; Winarno, Andreas S; Seliger, Gregor

    2017-07-15

    Mid-trimester preterm premature rupture of membranes (PPROM), defined as rupture of fetal membranes prior to 28 weeks of gestation, complicates approximately 0.4%-0.7% of all pregnancies. This condition is associated with a very high neonatal mortality rate as well as an increased risk of long- and short-term severe neonatal morbidity. The causes of the mid-trimester PPROM are multifactorial. Altered membrane morphology including marked swelling and disruption of the collagen network which is seen with PPROM can be triggered by bacterial products or/and pro-inflammatory cytokines. Activation of matrix metalloproteinases (MMP) have been implicated in the mechanism of PPROM. The propagation of bacteria is an important contributing factor not only in PPROM, but also in adverse neonatal and maternal outcomes after PPROM. Inflammatory mediators likely play a causative role in both disruption of fetal membrane integrity and activation of uterine contraction. The "classic PPROM" with oligo/an-hydramnion is associated with a short latency period and worse neonatal outcome compared to similar gestational aged neonates delivered without antecedent PPROM. The "high PPROM" syndrome is defined as a defect of the chorio-amniotic membranes, which is not located over the internal cervical os. It may be associated with either a normal or reduced amount of amniotic fluid. It may explain why sensitive biochemical tests such as the Amniosure (PAMG-1) or IGFBP-1/alpha fetoprotein test can have a positive result without other signs of overt ROM such as fluid leakage with Valsalva. The membrane defect following fetoscopy also fulfils the criteria for "high PPROM" syndrome. In some cases, the rupture of only one membrane - either the chorionic or amniotic membrane, resulting in "pre-PPROM" could precede "classic PPROM" or "high PPROM". The diagnosis of PPROM is classically established by identification of nitrazine positive, fern positive watery leakage from the cervical canal observed

  2. Adherence to good practices in membrane premature rupture. Perinatology Service. University Hospital “Dr. Gustavo Aldereguía Lima”, Cienfuegos city. From January to December 2002.

    Directory of Open Access Journals (Sweden)

    Yusimi Miranda Pérez

    2004-12-01

    Full Text Available Fundament:Nursing good practice demands standardizationof care,in such a way that they guide and unite the different ways of performance. Objetive: to determine the adherence of the care plan to the guide of good nursing practice in the premature rupture of the membranes and the level of the staff for the level of preparation for its performance in the Service of Perinatology. Methods: Descriptive, correlational and prospective study applied to 622 pregnant women admitted at the Perinatology Service of ¨Dr. Gustavo Aldereguía Lima¨ Hospital from Cienfuegos province who had a rupture of the membrane. 311 patients (50% of the universe, selected with probabilistic simple randomized way, without exclusive criteria were studied. Adherence was measured by using evaluation means. Results:43 % of the assessed clinical records, received between 95 and 100 points . Among the 16 nurses evaluated , 43,7 % had difficulties, being 25 % technicians.

  3. 未足月胎膜早破76例临床疗效分析%Clinical effect analysis of premature rupture of membranes in 76 cases

    Institute of Scientific and Technical Information of China (English)

    王文平

    2014-01-01

    目的 探讨未足月胎膜早破分娩母儿结局及处理方法.方法 选取2011年1月至2012年1月临汾市妇幼保健院产科住院分娩的头位未足月胎膜早破入院病例76例为胎膜早破组,选取同时间段的先兆早产孕妇80例为对照组,比较两组临床资料(胎儿窘迫、剖宫产、绒毛膜羊膜炎、新生儿窒息及围生儿死亡发生率).比较两组孕28~31+6周的绒毛膜羊膜炎发生率及孕周延长成功率,比较两组存活新生儿并发症发生情况.结果 胎膜早破组的胎儿窘迫、剖宫产、绒毛膜羊膜炎及新生儿窒息的发生率均明显高于对照组(x2=5.076,4.025,14.834,4.015,P=0.024,0.045,0.000,0.045).孕28~31+6周胎膜早破组的绒毛膜羊膜炎、病理确证绒毛膜羊膜炎发生率均明显高于对照组(x2=6.059,4.674,P=0.014,0.031).孕28 ~ 31+6周胎膜早破组延长孕周成功的发生率高于对照组(x2 =9.291,P=0.014,0.002).胎膜早破组的颅内出血、呼吸窘迫、高胆红素症、新生儿肺炎发生率均高于对照组(x2 =9.456,5.248,15.630,21.165,P=0.002,0.022,0.000,0.000).而孕周<34+6周的发生率则高于≥34+6周(x2 =8.900,5.594,10.312,10.880,P=0.003,0.018,0.001,0.001).结论 不同孕周的未足月胎膜早破者需予以不同的处理方式,通过对母体、胎儿及新生儿并发症的评估予以对应的治疗措施,从而在延长孕周提高新生儿存活率的同时降低母婴并发症的措施.%Objective To investigate the ending and handling methods of mothers and children with premature rupture of membranes.Methods Seventy-six cases of premature rupture of membranes from January 2011 to January 2012 in maternal and child health hospital of Linfen were selected as premature rupture of membranes group.Eighty cases of threatened premature labor gravida with the same period were chose as the control group.The clinical data(fetal distress,cesarean section,chorioamnionitis,neonatal asphyxia and death rate) between the

  4. Oligodramnia sem rotura das membranas amnióticas: resultados perinatais Oligohydramnios without premature rupture of membranes: perinatal outcomes

    Directory of Open Access Journals (Sweden)

    José Mauro Madi

    2005-02-01

    Full Text Available OBJETIVO: avaliar os resultados perinatais em casos de oligodramnia sem rotura de membranas amnióticas. MÉTODOS: foram estudados retrospectivamente 51 casos consecutivos de oligodramnia (índice de líquido amniótico (ILA menor que 5 cm em nascimentos ocorridos no período de março de 1998 a setembro de 2001. Compararam-se os dados obtidos aos de 61 casos com quantidade intermediária e normal de líquido amniótico (ILA >5 cm. Analisaram-se variáveis maternas e neonatais, bem como taxas de mortalidade fetal, neonatal precoce e perinatal. As avaliações estatísticas foram realizadas mediante a aplicação do teste não paramétrico do c² com a correção de Yates, e do teste t de Student. Adotou-se o nível de significância de 5%. RESULTADOS: não houve diferença significante entre os grupos estudados, ao se analisar a ocorrência de síndrome hipertensiva, presença de mecônio, índice de Apgar inferior a sete no primeiro e quinto minuto, internação na unidade de tratamento intensivo neonatal e prematuridade. A oligodramnia associou-se significantemente ao tipo de parto (pPURPOSE: to evaluate perinatal outcomes in cases of oligohydramnios without premature rupture of membranes. METHODS: a total of 51 consecutive cases of oligohydramnios (amniotic fluid index, AFI 5. Maternal and neonatal variables, as well as fetal mortality, early neonatal, and perinatal mortality rates were analyzed. For statistical analysis the c² test with Yates correction and Student's t test were used with level of signicance set at 5%. RESULTS: there were no significant differences between groups when the presence of gestational hypertensive syndromes, meconium-stained amniotic fluid, 1- and 5-minute Apgar score, need of neonatal intensive center unit, and preterm birth were analyzed. Oligohydramnios was associated with the way of delivery (p<0.0002; RR=0.3, fetal distress (p<0.0004; RR=2.2 and fetal malformations (p<0.01; RR=5.4. Fetal malformation rates

  5. Clinical Study on Treatment of Premature Rupture of Membranes%胎膜早破的临床治疗探讨

    Institute of Scientific and Technical Information of China (English)

    仝瑞华

    2013-01-01

    Objective:To explore the clinical treatment of patients withpremature rupture of membranes .Methods:analysis of 72 cases ofpremature rupture of fetal membranes in our hospital patients , symptomatic treatment of the .Results:after my courtyard careful treat-ment, patients were recovered, no death case.Conclusion:To improve the treatment level of premature rupture of membranes , can reduce maternal and neonatal mortality rate .%目的:探讨分析胎膜早破患者的临床治疗。方法:分析我院收治的72例胎膜早破患者,对其进行对症治疗。结果:经我院精心治疗,患者病情均康复,无死亡病例。结论:提高对胎膜早破的治疗水平,可减少产妇及新生儿的病死率。

  6. 胎膜早破早产合并生殖道感染的治疗%Treatment of Premature Rupture of Membrane and Reproductive Tract Infections

    Institute of Scientific and Technical Information of China (English)

    姜海利

    2011-01-01

    Premature delivery is a major concern of perinatal health care.Appropriate management of premature delivery is one of critical measures minimizing the perinatal mortality.Premature rupture of membrane ( PROM ) is the primary factor contributing to premature delivery whilst ascending reproductive tract infection is one of the major causes of PROM.In the case of PROM under 35 gestational weeks complicated with reproductive tract infection, proper antimicrobial treatment, prolongation of gestation, and acceleration of fetal lung maturity will reduce the perinatal mortality and greatly improve the ouctomes of mothers and babies.This article reviews treatments for PROM ( < 35 weeks ) complicated with reproductive tract infection.%早产是围生期保健的一个重要问题,早产的合理治疗是降低围生儿病死率的重要措施之一.胎膜早破是诱发早产的最主要因素,而生殖道病原微生物上行性感染则是胎膜早破的主要原因之一.对临床中<35周的胎膜早破早产合并生殖道感染患者,进行合理的控制感染、延长孕周、促胎肺成熟治疗,能降低围生儿病死率,显著改善母婴结局.现就胎膜早破早产(<35周)合并生殖道感染患者的治疗进行相关综述.

  7. Clinical and pathological features of infants with premature rupture of membranes%胎膜早破新生儿的临床病理特点

    Institute of Scientific and Technical Information of China (English)

    封志纯

    2008-01-01

    胎膜早破(premature rupture of fetal membranes,PRM)是指在临产前胎膜自然破裂。发生率约为5%~10%,是产科常见并发症,近年来,其发病率有增加的趋势[1]。PRM母婴容易发生一系列并发症,其新生儿并发症为典型母源性疾病之一。本文仅就PRM新生儿的临床病理作一归纳,以供同行参考。

  8. 89 Cases Analysis of Risk Factors for Premature Rupture of Membranes%89例胎膜早破的危险因素分析

    Institute of Scientific and Technical Information of China (English)

    欧敬忠

    2013-01-01

    目的研究分析124例胎膜早破的危险因素,为以后的临床防治胎膜早破提供可参考的依据。方法选取我院于2008年8月~2013年2月收治的523例新生儿以及产妇临床资料,对其进行回顾性分析,对可能引发胎膜早破发生相关危险因素对其进行 Logistic回顾分析。结果所选取的523例新生儿发生胎膜早破89例,发生率为17.0%。在本次研究中采用单因素分析法,在α=0.05水平初筛出4个同胎膜早破相关联的因素,主要为阴道炎、多次妊娠、妊娠期高血压疾病、妊娠合并糖尿病,经多因素Logistic回归分析法,对相关影响胎膜早破因素进行分析,阴道炎和多次妊娠是导致胎膜早破发生的危险因素。其中存在阴道炎和妊娠二次以上的孕妇发生胎膜早破的可能性更高。结论阴道炎和多次妊娠为导致胎膜发生早破的主要危险因素,对这些危险因素进行有效评估以及合理有效控制,可以有效预防以及降低出现胎膜早破病症。%Objective To study the risks of premature rupture of membrane to provide envidence in future works. Methods Choosed clinical data of 523 newborns and lying-in women to analyze retrospectly to study the risks of premature rupture of membrane from Agu. 2008 to Feb.2013. Results There were 89 cases happend premature rupture of membrane,the rate was 17.0%.There were 4 risk related factors of premature rupture of membrane,such as vaginitis,multiple pregnancy,hypertensive disorder complicating pregnancy,gestational diabetes mel itus.The most dangerous related factors were vaginitis,multiple pregnancy. Conclusion The main risk factors are vaginitis, multiple pregnancy,and we can prevent these factors by estimating and controlling.

  9. The analysis of risk factors of 89 cases of premature rupture of membrane%89例胎膜早破的危险因素分析

    Institute of Scientific and Technical Information of China (English)

    蒲莉

    2013-01-01

    目的:研究分析124例胎膜早破的危险因素,为以后的临床防治胎膜早破提供可参考的依据。方法:选取我院于2008年8月到2013年2月收治的523例新生儿以及产妇临床资料,对其进行回顾性分析,对可能引发胎膜早破发生相关危险因素对其进行Logistic回顾分析。结果:所选取的523例新生儿发生胎膜早破89例,发生率为17.0%。在本次研究中采用单因素分析法,在α=0.05水平初筛出4个同胎膜早破相关联的因素,主要为阴道炎、多次妊娠、妊娠期高血压疾病、妊娠合并糖尿病,经多因素Logistic回归分析法,对相关影响胎膜早破因素进行分析,其中存在阴道炎和妊娠二次以上的孕妇发生胎膜早破的可能性更高。结论:阴道炎和多次妊娠为导致胎膜发生早破的主要危险因素,对这些危险因素进行有效评估以及合理有效控制,可以有效预防以及降低出现胎膜早破病症。%Objective:To study the risks of premature rupture of membrane to provide envidence in future works. Methods:Choosed clinical data of 523 newborns and lying-in women to analyze retrospectly to study the risks of premature rupture of membrane from Agu. 2008 to Feb. 2013. Results:There were 89 cases happend premature rupture of membrane, the rate was 17.0%. There were 4 risk related factors of premature rupture of membrane, such as vaginitis, multiple pregnancy, hypertensive disorder complicating pregnancy, gestational diabetes mel itus. The most dangerous related factors were vaginitis, multiple pregnancy. Conclusion:The main risk factors are vaginitis, multiple pregnancy, and we can prevent these factors by estimating and control ing.

  10. The Value of the Soluable Intercellular Adhesion Molecule-1 Levelsin Matermal Serum for Determination of Occult Chorioamnionitis in Premature Rupture of Membranes

    Institute of Scientific and Technical Information of China (English)

    邹丽; 张会军; 祝建芳; 朱剑文

    2004-01-01

    To compare the diagnostic value of soluble intercellular adhesion molecule 1 (sICAM-1)with that of c-reactive protein (CRP) for detecting chorioamnionitis (CAM) in serum of women with premature rupture of membranes (PROM), 55 pregnant women with PROM, including 18pregnant women with preterm premature rupture of membranes (PPROM) and 20 normal pregnant women at term (TPROM) were studied. Maternal serum were measured by Sandwish enzymelinked immunoabsorbent assay (ELISA) for sICAM. CAM was histologically confirmed after delivery. The results revealed that (1) maternal serum levels of sICAM-1 and CRP were significantly higher in women with PROM than those without it; (2) maternal serum levels of sICAM-1 and CRP were significantly higher in women with CAM than those without it; (3) serum levels of sICAM-1 in PPROM women were similar to those in TPROM women, whereas serum levels of CRP in PPROM women were significantly higher than those in TPROM women; (4) the sensitivity,specificity, positive predictive value, negative predictive value, Kappa index and area under receiver operating characteristic (ROC) curve of maternal serum sICAM-1 (cutoff 104.7 ng/ml) and CRP (cutoff 1.03 mg/dl) for diagnosing CAM were 100 %, 91.2 %, 87.5 %, 100 %, 0.20, 0.995and 81.0 %, 73.5 %, 65.4 %, 86.2 %, 0.13, 0. 811, respectively; (5) among the mild histological CAM group, severe histological CAM group and clinical CAM group, the difference in maternal serum levels of sICAM-1 were significantly (P<0. 001), with the order of concentration from high level to low level corresponding to the severity of CAM. It is concluded that maternal serum level of ICAM-1 is superior to that of CRP as biomarker for diagnosing intraamniotic infection in pregnant women with PROM.

  11. LncRNA pathway involved in premature preterm rupture of membrane (PPROM: an epigenomic approach to study the pathogenesis of reproductive disorders.

    Directory of Open Access Journals (Sweden)

    Xiucui Luo

    Full Text Available Preterm birth (PTB is a live birth delivered before 37 weeks of gestation (GW. About one-third of PTBs result from the preterm premature rupture of membranes (PPROM. Up to the present, the pathogenic mechanisms underlying PPROM are not clearly understood. Here, we investigated the differential expression of long chain non-coding RNAs (lncRNAs in placentas of PTBs with PPROM, and their possible involvement in the pathogenic pathways leading to PPROM. A total number of 1954, 776, and 1050 lncRNAs were identified with a microarray from placentas of PPROM (group A, which were compared to full-term birth (FTB (group B, PTB (group C, and premature rupture of membrane (PROM (group D at full-term, respectively. Instead of investigating the individual pathogenic role of each lncRNA involved in the molecular mechanism underlying PPROM, we have focused on investigating the metabolic pathways and their functions to explore what is the likely association and how they are possibly involved in the development of PPROM. Six groups, including up-regulation and down-regulation in the comparisons of A vs. B, A vs. C, and A vs. D, of pathways were analyzed. Our results showed that 22 pathways were characterized as up-regulated 7 down-regulated in A vs. C, 18 up-regulated and 15 down-regulated in A vs. D, and 33 up-regulated and 7 down-regulated in A vs. B. Functional analysis showed pathways of infection and inflammatory response, ECM-receptor interactions, apoptosis, actin cytoskeleton, and smooth muscle contraction are the major pathogenic mechanisms involved in the development of PPROM. Characterization of these pathways through identification of lncRNAs opened new avenues for further investigating the epigenomic mechanisms of lncRNAs in PPROM as well as PTB.

  12. Research Advances in Molecular Biology of Premature Rupture of Membranes%胎膜早破的分子生物学研究进展

    Institute of Scientific and Technical Information of China (English)

    万丽娟

    2012-01-01

    Premature rupture of membranes is a common complication of obstetric , which may cause serious harms to the maternal and child. To ascertain the cause can contribute to a theoretical basis for the mechanisms of premature rupture of membranes, and is a practical guidance for early diagnosis and correct handling of the situation. Therefore, to study its causes and give proper treatment can greatly reduce the harm to the maternal and child, lower perinatal morbidity and mortality and is conducive to the delivery process. However, the complex causes are still not completely clear so far, and here is to make a review' on the causes on molecular level.%胎膜早破是产科一种常见的并发症,对母婴可造成很大伤害.明确病因有助于对胎膜早破的发生机制提供理论依据,对临床早期诊断、正确处理胎膜早破有实际指导意义.从病因出发,适时治疗可大大减少对母婴的危害,降低围生儿的发病率及病死率,有利于产妇的分娩.胎膜早破的病因复杂,至今仍未完全明确.现着重从分子水平对胎膜早破的病因予以综述.

  13. Clinical Analysis of 102 Cases with Preterm Premature Rupture of Mem-branes%早产合并胎膜早破102例临床分析

    Institute of Scientific and Technical Information of China (English)

    纪叶霞

    2015-01-01

    Objective To investigate the risk factors, delivery methods, treatment methods and outcomes of preterm prema-ture rupture of membranes (PPROM). Methods 102 cases with PPROM underwent hospitalization in our hospital from Jan-uary 2013 to October 2014 were selected as the subjects, which accounted for 1.9%of the 6256 cases delivered in our hos-pital during the same period. 311 cases had premature delivery, of which, PPROM cases accounted for 32.8%. A retrospec-tive analysis was conducted on it. Results The pathogenic factors of PPROM were mainly vaginitis (27.5%), abnormal fetal position (14.7%), twin pregnancy(11.8%), and unexplained reasons(25.4%). PPROM patients with different gestational weeks had different neonatal outcomes. Those with gestational weeks less than 34 had the highest perinatal mortality (25%), com-pared with the perinatal mortality occurred in those with other gestational weeks, the difference was statistically significant (P34周,胎肺基本达到成熟,可以进行自然生产,随时停止妊娠,需要时可以进行引产来终止妊娠.

  14. Clinical Analysis of Late Pregnancy With Preterm Premature Rupture of Membranes%妊娠晚期未足月胎膜早破临床分析

    Institute of Scientific and Technical Information of China (English)

    姜双艳

    2015-01-01

    目的:分析并研究妊娠晚期未足月胎膜早破的临床特点。方法选取我院收治的202例妊娠晚期未足月胎膜早破患者作为研究对象,对所有患者给予常规治疗,分析患者胎膜早破的原因,研究患者分娩方式和新生儿的出生情况。结果造成妊娠晚期未足月胎膜早破的原因是多方面的,最主要的原因是阴道炎,本研究组68例患者基于此原因(33.66%);其次是胎位不正,患者有27例(13.37%);原因不明的患者65例(32.18%)。本研究新生儿死亡18例,死亡率为8.91%,其中有11例新生儿死于重度窒息,还有7例死于肺部感染。结论妊娠晚期未足月胎膜早破主要由生殖道感染、胎位不正等因素造成,我们应为产妇选择合适的分娩方式,减少产妇和新生儿的安全隐患。%ObjectiveTo analyze the clinical characteristics of late pregnancy and preterm premature rupture of membranes.Methods 202 cases of late pregnancy PPROM patients as the research object, given conventional treatment to all patients, analysis of the reasons for premature rupture of membranes, study the mode of delivery and birth status of patients with newborn.Results The causes of late pregnancy with preterm premature rupture of membranes are in many aspects, the main reason is the vaginitis, The study group of 68 patients based on this reason (33.66%), followed by the malposition, patients have 27 cases, (13.37%), 65 cases of unexplained patients (32.18%). In this study, neonatal death in 18 cases, the mortality rate was 8.91%, 11 cases died of severe asphyxia neonates among them, and 7 cases died of pulmonary infection.ConclusionLate preterm pregnancy is mainly composed of reproductive tract infection, malposition and other factors, we should choose the appropriate mode of delivery for the pregnant, reduce security risks for mothers and newborns.

  15. [Prevention of spontaneous preterm birth (excluding preterm premature rupture of membranes): Guidelines for clinical practice - Text of the Guidelines (short text)].

    Science.gov (United States)

    Sentilhes, L; Sénat, M-V; Ancel, P-Y; Azria, E; Benoist, G; Blanc, J; Brabant, G; Bretelle, F; Brun, S; Doret, M; Ducroux-Schouwey, C; Evrard, A; Kayem, G; Maisonneuve, E; Marcellin, L; Marret, S; Mottet, N; Paysant, S; Riethmuller, D; Rozenberg, P; Schmitz, T; Torchin, H; Langer, B

    2016-12-01

    To determine the measures to prevent spontaneous preterm birth (excluding preterm premature rupture of membranes)and its consequences. The PubMed database, the Cochrane Library and the recommendations from the French and foreign obstetrical societies or colleges have been consulted. In France, premature birth concerns 60,000 neonates every year (7.4 %), half of them are delivered after spontaneous onset of labor. Among preventable risk factors of spontaneous prematurity, only cessation of smoking is associated to a decrease of prematurity (level of evidence [LE] 1). This is therefore recommended (grade A). Routine screening and treatment of vaginal bacteriosis in general population is not recommended (grade A). Asymptomatic women with single pregnancy without history of preterm delivery and a short cervix between 16 and 24 weeks is the only population in which vaginal progesterone is recommended (grade B). A history-indicated cerclage is not recommended in case of only past history of conisation (grade C), uterine malformation (Professional consensus), isolated history of pretem delivery (grade B) or twin pregnancies in primary (grade B) or secondary (grade C) prevention of preterm birth. A history-indicated cerclage is recommended for single pregnancy with a history of at least 3 late miscarriages or preterm deliveries (grade A).). In case of past history of a single pregnancy delivery before 34 weeks gestation (WG), ultrasound cervical length screening is recommended between 16 and 22 WG in order to propose a cerclage in case of lengthpremature rupture of membranes. Maintenance tocolysis is not recomended (grade B). Antenatal corticosteroid administration is recommended to every woman at risk of preterm delivery before 34 weeks of gestation (grade A). After 34 weeks, evidences are not consistent enough to recommend systematic antenatal corticosteroid treatment (grade B), however, a course might be indicated in the clinical situations associated with the

  16. Comparison of changes in etiologic microorganisms causing early-onset neonatal sepsis between preterm labor and preterm premature rupture of membranes.

    Science.gov (United States)

    Jeong, Heejeong; Han, Su-jin; Yoo, Ha-Na; Choi, Suk-Joo; Oh, Soo-Young; Kim, Yae-Jean; Roh, Cheong-Rae; Kim, Jong-Hwa

    2015-11-01

    To investigate changes in the etiologic microorganisms causing early-onset neonatal sepsis (EONS) in preterm labor (PTL) or preterm premature rupture of membranes (pPROM) cases over the past 16 years and to analyze the associated factors. We included consecutive singleton pregnancies delivered before 34 weeks due to PTL or pPROM. The etiologic microorganisms causing EONS in PTL and pPROM cases were compared between period 1 (1996-2004) and period 2 (2005-2012). There was no difference in the incidence of Gram-positive bacteria causing EONS between period 1 and 2, either in PTL (2.0% versus 2.1%, p = 1.0) or in pPROM (1.5% versus 1.6%, p = 1.0). However, the incidence of EONS caused by Gram-negative bacteria was significantly increased in pPROM (0.6% versus 2.7%, p = 0.040) during period 2, compared to period 1; but not in PTL (0.3% versus 1.2%, p = 0.211). Multivariable analysis revealed that a prolonged ROM-to-delivery interval (>7 d) was significantly associated with EONS caused by Gram-negative bacteria in pPROM (odds ratio: 6.6, 95% confidence interval: 1.4-31.8, p = 0.018). The etiologic microorganisms causing EONS have changed over the past 16 years in pPROM cases but not in PTL cases.

  17. Repercussões da amniorrexe prematura no pré-termo sobre a morbimortalidade neonatal Repercussions of premature rupture of fetal membranes on neonatal morbidity and mortality

    Directory of Open Access Journals (Sweden)

    Glaucio de Moraes Paula

    2008-11-01

    Full Text Available O objetivo foi analisar os fatores associados ao óbito e sobrevida com seqüela em neonatos egressos de gestações que cursaram com amniorrexe prematura. Estudo observacional do tipo coorte histórica analisou prontuários de pacientes que evoluíram com quadro de amniorrexe prematura The objective of this study was to analyze factors associated with death and survival with sequelae in neonates after premature rupture of fetal membranes (PROM. An observational historical cohort study analyzed charts of patients with PROM at < 34 weeks gestation. The variables were compared with neonatal death and survival with sequelae as the outcomes. In both groups, the data were submitted to bivariate analysis, and the variables showing significance were submitted to logistic regression. The final multivariate model for fetal death showed statistical significance for the following: chorioamnionitis; 5-minute Apgar score < 5; birth weight < 1,000g; and cardiopulmonary resuscitation. Survival with sequela was associated with: cervical colonization; patent ductus arteriosus; 5-minute Apgar score < 5; and birth weight < 1,000g. Infections, very low birth weight, and peripartum asphyxia were the principal variables associated with the target outcomes among newborns from gestations involving PROM.

  18. Fetal lung development on MRI. Normal course and impairment due to premature rupture of membranes; Fetale Lungenentwicklung in der MRT. Normaler Verlauf und Beeintraechtigung durch vorzeitigen Blasensprung

    Energy Technology Data Exchange (ETDEWEB)

    Kasprian, G. [Medizinische Universitaet Wien (Austria). Klinik fuer Radiodiagnostik; Zentrum fuer Anatomie und Zellbiologie der Medizinischen Universitaet Wien (Austria). Arbeitsgruppe Integrative Morphologie; Brugger, P.C. [Zentrum fuer Anatomie und Zellbiologie der Medizinischen Universitaet Wien (Austria). Arbeitsgruppe Integrative Morphologie; Helmer, H.; Langer, M. [Medizinische Universitaet Wien (Austria). Klinik fuer Frauenheilkunde; Balassy, C.; Prayer, D. [Medizinische Universitaet Wien (Austria). Klinik fuer Radiodiagnostik

    2006-02-15

    A well-organized interplay between many molecular factors as well as mechanical forces influence fetal lung development. At the end of this complex process a sufficiently sized and structurally mature organ should ensure the postnatal survival of the newborn. Besides prenatal ultrasonography, magnetic resonance imaging (MRI) can now be used to investigate normal and pathological human lung growth in utero. Oligohydramnios, due to premature rupture of membranes (PROM), is an important risk factor for compromised fetal lung growth. In these situations MR volumetry can be used to measure the size of the fetal lung quite accurately. Together with the evaluation of lung signal intensities on T2-weighted sequences, fetuses with pulmonary hypoplasia can be readily detected. (orig.) [German] Die fetale Lungenentwicklung wird einerseits durch eine Vielzahl molekularer Faktoren und andererseits durch mechanisch-physiologische Kraefte beeinflusst. Ein geordnetes Zusammenspiel dieser Mechanismen fuehrt zu einem ausreichend grossen und strukturell reifen Organ, das sofort nach der Geburt das Ueberleben des Neugeborenen sicherstellt. Neben der praenatalen Ultraschalluntersuchung bietet nun auch die Magnetresonanztomographie (MRT) die Moeglichkeit, die normale und pathologische fetale Lungenentwicklung zu untersuchen. Ein wesentlicher Risikofaktor fuer eine Beeintraechtigung der Lungenentwicklung ist die verminderte Fruchtwassermenge nach vorzeitigem Blasensprung. In diesen Faellen kann die MR-Volumetrie dazu eingesetzt werden, die Groesse der fetalen Lungen relativ genau zu bestimmen. Gemeinsam mit der Beurteilung der MR-Signalintensitaeten des Lungengewebes auf T2-gewichteten Sequenzen koennen Feten mit hypoplastischen Lungen mit zunehmender Sicherheit bereits praenatal identifiziert werden. (orig.)

  19. Maternal plasma levels of interleukin-6, C-reactive protein, vitamins C, E and A, 8-isoprostane and oxidative status in women with preterm premature rupture of membranes.

    Science.gov (United States)

    Ilhan, Nevin; Celik, Ebru; Kumbak, Banu

    2015-02-01

    Preterm premature rupture of membranes (PPROM) is associated with significant maternal and perinatal morbidity. This study examined maternal oxidative stress in PPROM. This was a prospective cross-sectional study conducted in a university hospital. A total of 72 pregnant women were recruited into two groups, those with PPROM (38 cases) and those without PPROM (34 controls) matched for gestational age. Plasma interleukin-6, C-reactive protein, vitamins C, E and A, 8-isoprostane, total oxidant status (TOS) and antioxidant status (TAS) were determined for all study participants and the data were compared between the PPROM and control groups. Both case and control groups were comparably matched in age, parity, gestational age and smoking status. There was a significant association between low 8-isoprostane, low vitamin C and high total oxidant status and the occurrence of PPROM (p vitamin C and 8-isoprostane levels were lower and TOS higher in women with PPROM. Further research is needed to identify robust biological markers for the prevention and also prognosis of PPROM.

  20. FOETOMATERNAL OUTCOME IN CASES OF PREMATURE RUPTURE OF MEMBRANE (PROM AT TERM: AN EXPERIENCE IN OUR INSTITUTE

    Directory of Open Access Journals (Sweden)

    Badam Rajani Kumari

    2016-08-01

    Full Text Available BACKGROUND Prelabour Rupture of Membranes (PROM remains a day-to-day problem for each and every obstetrician. Despite extensive research, most aspects of PROM remain unknown and as prevention of PROM is difficult one has to concentrate more on management of PROM to reduce its complications. AIM OF THE STUDY This study was aimed to understand incidence, causes, neonatal morbidity and mortality, maternal morbidity and mortality in cases of PROM and its effective management. MATERIAL AND METHODS A prospective hospital-based study was undertaken on 100 cases with PROM at term between 37 and 40 weeks in the Department of Obstetrics and Gynaecology during the period from April 2015 to March 2016. After delivery, APGAR scores at 1 minute were noted and those babies needing NICU admission were recorded. The causes for maternal morbidity were noted and results tabulated. RESULTS The incidence of PROM was highest in age group 20-29 years [49%] followed by age group less than 20 years [38%] and 13 cases [13%] in the age group above 30 years. In primigravida, the incidence was highest [58%]. PROM cases were higher in the below poverty line group [76%]. In 33%, no risk factors were identified. Maximum number of cases delivered within 7-12 hours of PROM [69%]. Most of the women delivered vaginally either spontaneously or after induction with misoprostol in 66% of cases. 88 babies [88%] had Apgar score 8-10. Most common complication in the mother was fever [12%] and in the newborn was septicaemia [6%]. CONCLUSION PROM is associated with increased maternal and perinatal complications especially when duration of PROM is more than 12 hours. Identifying known risk factors, proper counseling, and prompt treatment of infections either UTI or vaginal is mandatory

  1. Clinical Research of Treatment of Bacterial Vaginosis in Pregnancy to Prevent Premature Rupture%治疗妊娠期细菌性阴道病对预防胎膜早破的临床研究

    Institute of Scientific and Technical Information of China (English)

    张霞; 杜鹃

    2013-01-01

    Objective?To research treatment bacterial vaginosis during pregnancy whether can prevent premature rupture of membranes from occur or not. Methods 121 cases of bacterial vaginosis during pregnancy, who gestate over two months, was divided into two group. The treatment group was given the lactobacillus vagina capsule treatment. The control group did nothing. Comparison of premature rupture of membranes occurrence rates between the two groups. Results The occurrence rate of premature rupture of membranes in treatment group was 8.33%, another was 18.46%. Conclusion Positive treatment bacterial vaginosis during pregnancy, can lower the occurrence rate of premature rupture of membranes effectively.%目的:研究治疗妊娠期细菌性阴道病对预防胎膜早破的影响。方法共选择孕2个月以上妊娠期细菌性阴道病患者363例,分为2组。治疗组给予外用乳酸菌阴道胶囊进行治疗,对照组未进行干预。分别观察2组患者胎膜早破发生率。结果治疗组胎膜早破发生率8.33%,对照组胎膜早破发生率18.46%。结论妊娠期积极治疗细菌性阴道病,可有效降低胎膜早破的发生率。

  2. The clinical observation and nursing for pregnant women who get premature rupture of fetal membranes%胎膜早破孕产妇的临床观察及护理

    Institute of Scientific and Technical Information of China (English)

    贺建华; 任春秀

    2013-01-01

    目的探讨对胎膜早破孕产妇进行有效护理的重要性。方法回顾性分析42例胎膜早破孕产妇的临床观察及护理情况。结果42例胎膜早破患者,28例阴道分娩,14例剖宫产,无1例发生宫腔感染和新生儿死亡。结论通过对胎膜早破患者进行严密的观察和护理,同时做好产前检查,积极预防,依据情况终止妊娠,可提高新生儿存活率,减少并发症的发生。%Objective To explore the importance of premature rupture of membranes were effective nursing. Methods 42 cases of premature rupture of the membranes were analyzed,the prevention and nursing. Results Of the 42 patients with PROM,28 cases of vaginal delivery,14 cases of cesarean section,with no occurrence of intrauterine infection and neonatal death. Conclusion The premature rupture of membranes were obse rved and nursing closely,at the same time,antenatal care.

  3. Early Diagnosis and Treatment of Premature Rupture of Membranes Complicated by Placental Abruption%胎膜早破并发胎盘早剥的早期诊治分析

    Institute of Scientific and Technical Information of China (English)

    朱永宁

    2016-01-01

    Objective The premature rupture of membranes complicated with placental abruption early clinical diagnosis and treatment research.Method 40 cases of premature rupture of membranes in our hospital from June 2011 to June 2014 were abruption as the object of study, of which 15 cases complicated with premature rupture of membranes, 27 cases did not appear placental abruption, the clinical data of all patients were retrospectively analyzed.Results The main cause is the inducement of placental abruption placental abruption, followed by gestational hypertension; patients with placental abruption occurred in 8.02% of premature rupture of membranes.Conclusion In clinical practice, premature rupture of membranes is one of the important factors of placental abruption, therefore, should be closely in patients with clinical manifestations, and strengthen the monitoring of fetal heart rate and B ultrasound examination, for early detection, early treatment, and protect the mother and child health.%目的:对胎膜早破并发胎盘早剥的早期临床诊治进行探究。方法择选我院2011年6月至2014年6月所收治的40例胎膜早剥作为研究的对象,其中有15例并发胎膜早破,27例未出现胎盘早剥,对全部患者的临床资料进行回顾性分析。结果引发胎盘早剥的主要诱因是胎盘早剥,其次是妊娠期高血压;胎膜早破患者发生胎盘早剥的发生率为8.02%。结论在临床上,胎膜早破是诱发胎盘早剥的一个重要因素,因此,应密切患者的临床表现,且加强胎心监护与B超检查,以便及早发现、及早治疗,继而保障母婴的生命健康。

  4. Clinical survey on incidence of premature membrane rupture in 2544 pregnant women%2544例孕妇胎膜早破发病情况调查

    Institute of Scientific and Technical Information of China (English)

    高桂卿; 马巧玉; 关怀; 尚丽新

    2015-01-01

    目的:回顾性调查胎膜早破( premature rupture of membrane,PROM)在大样本孕妇人群中发病情况,为深入了解该病特点及协助孕期管控提供依据。方法选取2544例孕妇进行回顾性分析,采集孕妇人口学特征、孕产史、孕期维生素服用情况及孕期患病情况,以不同条件分组,统计各组PROM发病率,分析PROM发生的潜在危险因素。结果(1)2544例孕妇,发生PROM共392例,发生率为15.4%;(2)受教育程度低、孕期被动吸烟、孕期发生泌尿生殖道感染、孕期合并或并发糖尿病以及孕期服用复合维生素时间较长的孕妇PROM发生率显著升高( P<0.05);(3)随年龄和流产次数增加,PROM发生率呈升高趋势( P<0.05)。结论高龄、学历低、多次流产史、被动吸烟、泌尿生殖道感染、孕期糖尿病以及孕期服用复合维生素时间长可能是孕妇发生PROM的危险因素;孕期服用复合维生素与PROM发生的关系值得进一步研究。%Objective To survey the incidence of premature rupture of membrane ( PROM) in a large sample of pregnant women to provide a basis for further understanding the disease and its clinical treatment.Methods We enrolled 2544 preg-nant women in the study and conducted a retrospective analysis.Demographic characteristics were investigated.Potential risk factors were analyzed.Results ( 1 ) In 2544 pregnant women, 392 patients had PROM with an incidence rate of 15.4%.(2) Mothers with lower education and urinary and reproductive system infection, exposed to passive smoking, complicated with diabetes mellitus and taking vitamin compound preparations for relatively long time during pregnancy had significantly higher incidence of PROM (P<0.05).(3) Incidence of PROM increased with maternal age and times of a-bortion (P<0.05).Conclusions Some demographic characteristics, repeated abortion history and some adverse events during pregnancy are

  5. 未足月胎膜早破影响因素研究进展%Progress of influence factors on premature rupture of membranes

    Institute of Scientific and Technical Information of China (English)

    徐晖

    2015-01-01

    Premature rupture of membranes (PPROM) is one of the common complications of obstetrics, which has a serious impact on maternal and infant health. It is also a common cause of fetal death. The cause of fetal death has not been determined. Domestic and foreign studies have found that it may be impacted by many factors such as maternal infection, injury, trace element deficiency, cervical function and fetal development. In recent years, with the progress of molecular medicine research, it found that matrix metalloproteinases (MMPs), apoptosis and PPROM have a correlation. This article reviews the progress of PPROM.%未足月胎膜早破(PPROM)是产科常见妊娠并发症之一,对母婴健康具有严重影响,也是导致胎儿死亡的常见病因,其诱发因素比较,发病机制尚未确定,国内外研究认为母体感染、创伤、微量元素缺乏、宫颈功能及胎儿发育等多种因素有关,近年来随着分子医学研究的进展,发现基质金属蛋白酶( MMPs)、细胞凋亡与PPROM已具有相关性,现本文就PPROM影响因素研究进展进行综述。

  6. [Cytological-energetic principle of the amniotic fluid examination on female patients with diagnosis of preterm premature rupture of membranes - up to now experiences and perspectives].

    Science.gov (United States)

    Müllerová, K; Kelbich, P; Švecová, M

    2015-12-01

    In our study we have dealt with the amniotic fluid examination on female patients with diagnosis of preterm premature rupture of membranes (PPROM). For one of the most important task in the feto-maternal medicine we consider the discovered method of amniotic fluid examination which is capable of the earliest possible detection in an intraamniotic inflammatory response. Unnoticed could harm or in the most serious cases threat the life of fetus or its mother. This was also the main reason why we chose this topic for our study. We have not been interested only in already known interleu-kin-6 (IL-6), but we have approached the examination comprehensively. We used the cytological-energetic principle supplemented by the examination of aspartate-amino-transferase (AST), in which already are long-term experiences in investigating other extracellular fluids. We have monitored values of C-reactive protein (CRP) and leucocytes in maternal serum, IL-6, AST and energetic score ratio (KEB) in amniotic fluid. Further we have investigated which imunocompetent cells have been dominant in amniotic fluid at different types of inflamantory reaction. According to the results of the examination of the control groups, it was necessary to correct the KEB limit in comparison to KEB limits of other extracellular fluids. Although our study includes untill now only 44 patients - 21 controls and 23 investigated persons, we have been already able to find out some trends of changes in observed parametres. As a very impotant discovery we consider the fact, that KEB, AST and cytological examination of amniotic fluid seem to be the methods for prediction of chorioamnionitis as reliable as the examination of IL-6. These methods are besides less expensive and therefore more suitable for the use in the small hospitals and developing countries. We continue in our study to confirm the previously found trends on the larger numbers of patients.

  7. Effects of Ascorbic Acid on Serum Level of Unconjugated Estriol and Its Relationship with Preterm Premature Rupture of Membrane: A Double-Blind Randomized Controlled Clinical Trial

    Directory of Open Access Journals (Sweden)

    Mehrangiz Zamani

    2013-09-01

    Full Text Available Background: Vitamin C is a water-soluble antioxidant that not only stimulates and protects collagen synthesis but also plays an important role in maintaining cellular integrity in a normal pregnancy. This study surveyed the effects of ascorbic acid on the serum level of unconjugated estriol and the relationship between unconjugated estriol and preterm premature rupture of membrane (PPROM. Methods: This double-blind, randomized clinical trial recruited 60 patients with predisposing factors to PPROM. The women were randomly divided into two groups of intervention and control and received vitamin C and placebo, respectively. The intervention group received 250 mg vitamin C twice a day and the controls received the placebo only. Unconjugated estriol was measured using the ELISA. All data were extracted and recorded in a checklist and compared using descriptive statistics as well as the x2, Fisher exact, and t tests. Results: The demographic data showed no difference between the two groups. The mean level of serum unconjugated estriol was significantly lower in the intervention group than in the control group (P=0.044. Also, the frequency of PPROM was lower in the intervention group, but the difference was not significant (P>0.05. Unconjugated estriol levels were not significantly different between the healthy women and the PPROM patients. Conclusion: This study demonstrated that vitamin C administration decreased unconjugated estriol levels in the patients with PPROM. The findings of this study also indicated that administration of ascorbic acid was a safe and effective method to reduce the incidence of PPROM. Alteration in unconjugated estriol is an active mediator for this effect. Trial Registration Number: IRCT201012083580N3

  8. Analysis of risk factors for brain injury in preterm infants after preterm premature rupture of membranes%未足月胎膜早破后早产儿脑损伤的相关危险因素分析

    Institute of Scientific and Technical Information of China (English)

    卢红艳; 常明; 吴丽华

    2012-01-01

    目的:分析未足月胎膜早破后早产儿脑损伤的高危因素.方法:对2008年1月~ 2010年10月在医院产科出生且生后即转入新生儿科的未足月胎膜早破后早产儿及母亲的临床资料进行回顾性分析,按早产儿生后有无脑损伤分为脑损伤组与无脑损伤组.对患儿胎龄、出生体质量、性别、母亲有无绒毛膜羊膜炎、羊水指数、母亲产前应用激素、破膜时间、分娩方式、胎儿宫内窘迫、窒息复苏10个项目进行分析.结果:137例早产儿符合研究标准,未足月胎膜早破后早产儿脑损伤发生率24.8%.早产儿脑损伤危险因素Logistic回归分析按OR值排序,依次为胎龄、出生体重、窒息复苏及母亲绒毛膜羊膜炎.破膜时间长短与脑损伤无关.结论:未足月胎膜早破后早产儿脑损伤的发生与多因素有关,胎龄越小、体重越低脑损伤发生率越高,母亲绒毛膜羊膜炎及患儿生后有窒息复苏史也为早产儿脑损伤高危因素.%Objective; To explore the high risk factors of brain injury in preterm infants after preterm premature rupture of membranes. Methods: Data were collected retrospectively among preterm infants after preterm premature rupture of membranes who were borne in obstetrics and admitted to neonatal intensive care unit in our hospital from Jan. 2008 to Oct. 2010. All subjects were divided into brain injury group and no brain injury group. Logistic regression was adopted to analyze 10 factors; gestational age, birth weigh, sex, mother chorio-amnionitis, amniotic fluid index, antenatal steroids therapy to mothers, latency after preterm premature rupture of membranes, delivery ways, fetal distress in uterus, asphyxiate resuscitation. Results: Among 137 preterm infants, 33 cases ( 24.8% ) were detected with brain injury. Risk factors for brain injury in preterm infants after preterm premature rupture of membranes were arranged as follows according to odds ratio (OR) value

  9. Influence of Premature Rupture of Membranes on Neonatal and Maternal Outcomes%胎膜早破对母婴结局的影响

    Institute of Scientific and Technical Information of China (English)

    陈悦群; 王志华

    2012-01-01

    Objective To observe the influence of premature rupture of membranes (PROM) on neonatal and maternal outcomes. Methods From January 2003 to December 2010, the clinica! data of 2405 cases of singleton pregnancy with PROM were recorded, and the incidence rate of neonatal and maternal infection were analyzed. All cases were stratified according to the duration of PROM into two groups; 0. 05 ). Conclusion PROM is harmful to the health of neonatal and maternal. Maternal infection highly suggests the possibility of neonatal infection. The patients of PROM with different gestation weeks and time from membrane rupture to delivery should be treated with different methods to reduce the incidence of neonatal and maternal infection.%目的 探讨胎膜早破对母婴结局的影响.方法 详细记录笔者医院2003年1月~2010年12月收治的2405例单胎胎膜早破孕妇的临床资料,观察母婴感染率.按破膜距分娩时间长短将胎膜早破孕妇分为< 12h组和≥12h组,观察破膜距分娩时间与绒毛膜羊膜炎发生率、母婴感染率的关系.比较83例感染孕妇和2322例未感染孕妇的新生儿感染发生率.将83例伴有新生儿感染的胎膜早破孕妇分成未足月胎膜早破组和足月胎膜早破组,观察两组新生儿的临床结局.结果 2405例胎膜早破患者中,孕妇感染83例,占3.45%,新生儿感染72例,占2.99%.与破膜距分娩时间<12h组相比,≥12h组绒毛膜羊膜炎发生率显著增加(P<0.01),母婴感染率明显增高(P<0.01).感染孕妇组的新生儿感染率高于未感染孕妇组.与足月组相比,未足月胎膜早破组胎儿宫内窘迫率及新生儿感染率明显升高(P<0.05),但两组分娩方式无显著差异(P>0.05).结论 胎膜早破严重影响母婴健康,发生感染的孕妇更易发生新生儿感染.对于不同孕周、破膜时间长短不同的胎膜早破孕妇应采取相对应的治疗措施以降低母婴感染并发症.

  10. Risk factors for premature rupture of membranes and clinical management of different gestational weeks%早产胎膜早破的危险因素、不同孕周临床处理方式探讨

    Institute of Scientific and Technical Information of China (English)

    王颖

    2016-01-01

    目的:探讨早产胎膜早破的危险因素及其不同孕周临床处理方式。方法选取2013年2月~2014年2月来院治疗的早产胎膜早破孕妇86例作为研究对象,分析其危险因素及不同孕周处理方式。结果生殖道感染、胎位异常、流产引产史是引起早产胎膜早破的主要危险因素;观察组剖宫产率(8.89%)明显低于对照组剖宫产率(26.83%),差异有统计学意义(P<0.05);观察组新生儿窒息、新生儿感染、呼吸窘迫、新生儿死亡发生率明显较对照组高,差异均有统计学意义(P<0.05)。结论根据不同孕周对早产胎膜早破采取不同的临床处理方式,做好孕前检查,可有效避免早产胎膜早破的发生,改善妊娠结局。%Objective To investigate the risk factors of preterm premature rupture of membranes and the treatment methods of different gestational weeks. Methods 86 cases of preterm premature rupture of membranes in the hospital from February 2013 to February 2014 were selected as the research objects. The risk factors and treatment methods of the different gestational weeks were analyzed.Results Reproductive tract infection, abnormal fetal position, history of abortion, abortion is caused by premature labor and premature rupture of membranes(PROM) is a major risk factor; the observation group, the rate of cesarean section(8.89%) was significantly lower than that of the control group, the rate of cesarean section(26.83%), the difference is statistically significant; Observation group of neonatal asphyxia, neonatal infection, respiratory distress, neonatal death rate was significantly higher than the control group, the differences were statistically significant.Conclusion According to different gestational weeks of preterm premature rupture of membranes early broken take different clinical treatment methods, to do pre pregnancy check, can effectively prevent preterm premature rupture of membranes

  11. Previous prelabor or intrapartum cesarean delivery and risk of placenta previa.

    Science.gov (United States)

    Downes, Katheryne L; Hinkle, Stefanie N; Sjaarda, Lindsey A; Albert, Paul S; Grantz, Katherine L

    2015-05-01

    The purpose of this study was to examine the association between previous cesarean delivery and subsequent placenta previa while distinguishing cesarean delivery before the onset of labor from intrapartum cesarean delivery. We conducted a retrospective cohort study of electronic medical records from 20 Utah hospitals (2002-2010) with restriction to the first 2 singleton deliveries of nulliparous women at study entry (n=26,987). First pregnancy delivery mode was classified as (1) vaginal (reference), (2) cesarean delivery before labor onset (prelabor), or (3) cesarean delivery after labor onset (intrapartum). Risk of second delivery previa was estimated by previous delivery mode with the use of logistic regression and was adjusted for maternal age, insurance, smoking, comorbidities, previous pregnancy loss, and history of previa. Most first deliveries were vaginal (82%; n=22,142), followed by intrapartum cesarean delivery (14.6%; n=3931), or prelabor cesarean delivery (3.4%; n=914). Incidence of second delivery previa was 0.29% (n=78) and differed by previous delivery mode: vaginal, 0.24%; prelabor cesarean delivery, 0.98%; intrapartum cesarean delivery, 0.38% (Pprevia (adjusted odds ratio, 2.62; 95% confidence interval, 1.24-5.56). There was no significant association between previous intrapartum cesarean delivery and previa (adjusted odds ratio, 1.22; 95% confidence interval, 0.68-2.19). Previous prelabor cesarean delivery was associated with a >2-fold significantly increased risk of previa in the second delivery, although the approximately 20% increased risk of previa that was associated with previous intrapartum cesarean delivery was not significant. Although rare, the increased risk of placenta previa after previous prelabor cesarean delivery may be important when considering nonmedically indicated prelabor cesarean delivery. Published by Elsevier Inc.

  12. Prior Prelabor or Intrapartum Cesarean Delivery and Risk of Placenta Previa

    Science.gov (United States)

    Downes, Katheryne L.; Hinkle, Stefanie N.; Sjaarda, Lindsey A.; Albert, Paul S.; Grantz, Katherine L.

    2015-01-01

    Objective To examine the association between previous cesarean delivery and subsequent placenta previa while distinguishing cesarean delivery prior to onset of labor from intrapartum cesarean delivery. Study Design Retrospective cohort study of electronic medical records from 20 Utah hospitals (2002–2010) with restriction to the first two singleton deliveries of women nulliparous at study entry (n=26,987). First pregnancy delivery mode was classified as 1) vaginal (reference); 2) cesarean delivery prior to labor onset (prelabor); or 3) cesarean delivery after labor onset (intrapartum). Risk of second delivery previa was estimated by prior delivery mode using logistic regression and adjusted for maternal age, insurance, smoking, co-morbidities, prior pregnancy loss, and history of previa. Results The majority of first deliveries were vaginal (82%, n=22,142), followed by intrapartum cesarean delivery (14.6%, n=3,931), or prelabor cesarean delivery (3.4%, n=914). Incidence of second delivery previa was 0.29% (n=78) and differed by prior delivery mode: vaginal, 0.24%; prelabor cesarean delivery, 0.98%; intrapartum cesarean delivery, 0.38% (Pprevia (adjusted odds ratio, 2.62 [95% confidence interval, 1.24–5.56]). There was no significant association between prior intrapartum cesarean delivery and previa [adjusted odds ratio, 1.22 (95% confidence interval, 0.68–2.19)]. Conclusion Prior prelabor cesarean delivery was associated with a more than two-fold significantly increased risk of previa in the second delivery, while the approximately 20% increased risk of previa associated with prior intrapartum cesarean delivery was not significant. Although rare, the increased risk of placenta previa after prior prelabor cesarean delivery may be important when considering non-medically indicated prelabor cesarean delivery. PMID:25576818

  13. Retrospective Analysis of Preterm Premature Rupture of Membranes%未足月胎膜早破对围产儿结局影响因素的分析

    Institute of Scientific and Technical Information of China (English)

    陈婷; 姚穗

    2012-01-01

    [Objective]To explore the factors of pregnancy outcomes during expectant management of neo-nates with preterm premature rupture of membranes (PPROM). [Methods]Clinical data of 50 pregnant women with premature rupture of membranes and a gestational age from 26 to 34 weeks treated in our hospital from Jan. 2008 to May 2010 were analyzed retrospectively. [Results]Tocolyis time in survival newborn group were significantly longer than that in dead newborn group( P 0. 05). Tocolyis time in oligohydramnios group was significantly shorter than that in normal amniotic fluid group( P 0.05);②羊水过少组的保胎时间显著短于羊水正常组(P<0.01),新生儿呼吸窘迫综合征(NRDS)的发生率也高于羊水正常组(P<0.05),羊水正常组新生儿存活率显著高于羊水过少组(P<0.05).[结论]对远离足月的胎膜早破(PROM) 患者,较高的羊水指数,就能为保胎赢得时间,从而提高了妊娠结局.

  14. The influence of antibiotic application time on delivery outcom after premature rupture of membranes%抗生素应用时间对胎膜早破分娩结局的影响

    Institute of Scientific and Technical Information of China (English)

    武鹤立; 桑霞

    2013-01-01

    目的 探讨胎膜早破发生后抗生素使用时间与分娩结局之间的关系及抗生素使用对分娩结局的影响.方法 选取住院分娩的474例胎膜早破产妇作为研究对象,根据胎膜早破时间分组,其中在破水后12h之内者分为A组,共284例,随机分为A1组与A2组,分别为142例;在破水后12 ~24 h之内者为B组,共120例;破水后24h后者为C组,共70例.A2组、B组、C组均给与抗生素静脉滴注,A1组不给予静脉滴注,观察妊娠结局.结果 B组与A组、C组与A组分娩方式、胎儿宫内窘迫、新生儿窒息、绒毛膜羊膜炎发生率差异均有统计学意义(均P<0.05);A2组与A1组分娩方式、胎儿宫内窘迫、新生儿窒息、绒毛膜羊膜炎发生率差异均无统计学意义(均P>0.05).结论 破水12 h之内产妇如无明确证据证明有感染的情况下可以不使用抗生素,是否使用抗生素并不影响分娩结局.%Objective To explore the relationship between antibiotic application time and delivery outcome after the premature rupture of membranes,and to explore the effect of using antibiotics to delivery outcome.Methods 474 premature rupture of fetal membranes parturient who deliver in our desk work were selected as study objects.According to the time of premature rupture of membranes,the patients were dividwd into groups.The patients that bear children within 12h after the membrane rupture are divided into A group.A group had 284 cases and they were randomly divided into two groups,A1 group and A2 group,both of which had 142 cases.The patients that beared children within 12 ~ 24h after the membrane rupture were divided into B group.B group had 120 cases.The patients that beared children 24h after the membrane rupture were divided into C group.C group had 70 cases.A2 group,B group and C group were all given antibiotic intravenous infusion,A1 group was not given that.The pregnancy outcome was observed.Results B group and A group,C group and A

  15. Oxytocin and oral misoprostol for labor induction in prelabor rupture of membranes

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    Rashmi

    2016-02-01

    Conclusions: Although oxytocin resulted in shorter induction to delivery interval, oral misoprostol is still an effective option for PROM, as delivery and neonatal outcomes were similar. [Int J Reprod Contracept Obstet Gynecol 2016; 5(2.000: 379-383

  16. 单胎头位未足月胎膜早破120例的临床分析%Clinical analysis of 120 cases of preterm premature rupture of membranes in single fetal head position

    Institute of Scientific and Technical Information of China (English)

    钟丽; 李发红; 宋振霞; 范冬梅

    2015-01-01

    目的:探讨未足月胎膜早破(PPROM)的临床处理及其对母婴结局的影响。方法:收治单胎头位PPROM孕妇120例,分析不同孕周产妇的宫内感染率、分娩方式和新生儿结局。结果:Ⅰ组宫内感染率84.75%,明显高于Ⅱ组的54.10%(P<0.01);Ⅰ组新生儿窒息、感染、死亡的比例均明显高于Ⅱ组(P<0.01)。结论:孕周28~33+6周胎膜早破孕妇要积极保胎治疗,尽量延长孕周,促进胎儿肺成熟,预防性应用抗生素,降低母儿感染率,减少极不成熟早产儿的出生。孕周>34周且未满37周的胎膜早破孕妇应尽早终止妊娠,降低母体及新生儿的感染发生率。%Objective:To explore the clinical treatment and its effect on maternal and infant outcomes of preterm premature rupture of membranes(PPROM).Methods:120 cases of PPROM pregnant women in single fetal head position were selected.The intrauterine infection rates,delivery modes and neonatal outcomes of different gestational age women were analyzed.Results:The intrauterine infection rate(84.75% ) in Ⅰ group was significant higher than 54.10% of Ⅱ group(P<0.01).The proportions of neonatal asphyxia,infection,death were all significant higher than that of Ⅱ group(P<0.01).Conclusion:The pregnant women with premature rupture of membranes of gestational age at 28~33 + 6 weeks should be given actively medicine theraphy.It can try to extend the gestational age,promote the fetal lung maturity,give prophylactic antibiotics,reduce the infection rate of mother and infant,and reduce the birth of very immature infants.The pregnant women with premature rupture of membranes of gestational age more than 34 weeks and less than 37 weeks should be given terminate pregnancy as early as possible,it reduces the incidence rate of maternal and neonatal infection.

  17. Analysis in effect of nursing intervention in prevention of premature rupture of the membrane infection%护理干预对预防未足月胎膜早破感染的效果分析

    Institute of Scientific and Technical Information of China (English)

    温泰芳; 胡小云; 李晓红

    2009-01-01

    目的 探讨护理干预对预防未足月胎膜早破感染的效果.方法 将131例未足月胎膜早破的产妇分为对照组65例和实验组66例,分别采取常规护理方法和护理干预,比较2组孕期、围生儿情况以及实验室感染指标监测情况.结果 2组在年龄、入院孕周、分娩孕周、距分娩时间、新生儿体质量方面比较差异无统计学意义;新生儿Apgar评分、新生儿死亡2组间比较差异显著.结论 在未足月胎膜早破的积极护理治疗中,必须对感染指标进行监测,做好预防感染的护理,一旦出现感染先兆必须终止妊娠.%Objective To investigate the role of nursing intervention in the prevention of premature rupture of the membrane infection. Methods 131 patients with premature rupture of the membrane were divided into the control group(65 cases) and the experimental group(66 cases), they adopted routine nursing method and nursing intervention respectively. The duration of pregnancy, fetal condition and laboratory tests for infection were compared between two groups. Results No significant differences were found between the two groups in terms of age, duration of pregnancy, newborn weight. Significant differences were observed in Apgar score, newborn death between two groups. Conclusions Monitoring for signs of premature rupture of the membrane such as infection and laboratory tests are important for the prevention of infeclion, if infection occurs, delivery may be necessary to prevent further complications.

  18. Clinical Efficacy Observation on Combined Treatment of Anpo and Magnesium Sulfate for Premature Rupture Membrane%安宝与硫酸镁联合治疗早产胎膜早破的疗效观察

    Institute of Scientific and Technical Information of China (English)

    李海东

    2012-01-01

    目的 探讨安宝与硫酸镁联合治疗早产胎膜早破的临床疗效.方法 90例早产胎膜早破孕妇按随机数字表法分为三组,各30例.对照Ⅰ组给予硫酸镁,对照Ⅱ组给予安宝,观察组联合安宝与硫酸镁.观察三组的疗效、显效时间、起效时间、延长妊娠时间及不良反应.结果 对照Ⅰ组总有效率低于对照Ⅱ组和观察组(P<0.05);对照Ⅰ组显效时间、起效时间晚于对照Ⅱ组和观察组,延长妊娠时间小于对照Ⅱ组和观察组(P<0.05);对照Ⅱ组不良反应发生率显著高于对照Ⅰ组(P<0.05).结论 安宝与硫酸镁联合治疗早产胎膜早破显效快,延长妊娠时间长,疗效好,不良反应少,值得临床推广应用.%Objective To study the clinical efficacy of Anpo and magnesium sulfate as a combined treatment for premature rupture membrane. Methods 90 pregnant women with premature rupture membrane were randomized into three groups,30 patients per group. The three groups were respectively regarded as the control group Ⅰ ( treated with magnesium sulfate ),the control group Ⅱ ( treated with Anpo )and the observation group( treated with Anpo and magnesium sulfate ). The clinical efficacy, the excellent effective time, the effective time, prolonged pregnancy time and adverse reactions were observed. Results Compared with control group Ⅱ and the observation group, the total effective rate was obviously lower in control Ⅰ group( P < 0. 05 ). Compared with the control group Ⅱ and the observation group,the excellent effective time and the effective time were obviously longer and the prolonged pregnancy time was significantly lower in control Ⅰ group( P<0.05 ). The adverse reactions were significantly higher in control group Ⅱ than control group Ⅰ ( P <0. 05 ). Conclusion The clinical efficacy of the combination treatment of Anpo and magnesium sulfate for premature rupture memherane is featured with fast, longer prolonged pregnancy time, good

  19. Research of application effect by humanized nursing in puerpera with preterm premature rupture of membranes%人性化护理在未足月胎膜早破产妇中的应用效果研究

    Institute of Scientific and Technical Information of China (English)

    纪梅芳

    2015-01-01

    目的:探究人性化护理在未足月胎膜早破产妇中的应用效果。方法60例未足月胎膜早破产妇随机分为对照组和观察组,每组30例。对照组采用常规护理,观察组采用人性化护理,比较分析两组患者的产后出血率以及新生儿Apgar评分情况。结果观察组的产后出血率10.00%,新生儿Apgar评分(9.31±0.58)分;对照组分别为33.33%,(8.07±0.66)分。观察组的产后出血率、新生儿Apgar评分均优于对照组,差异具有统计学意义(P<0.05)。结论对未足月胎膜早破产妇采用人性化护理能够降低其产后出血率,提高新生儿Apgar分值,值得临床推广。%Objective To explore application effect by humanized nursing in puerpera with preterm premature rupture of membranes.Methods A total of 60 puerpera with preterm premature rupture of membranes were randomly divided into control group and observation group, with 30 cases in each group. The control group received conventional nursing, and the observation group received humanized nursing. Postpartum hemorrhage rate and neonatal Apgar score were compared between the two groups.Results The observation group had postpartum hemorrhage rate as 10.00% and neonatal Apgar score as (9.31±0.58) points, and the control group had those as 33.33% and (8.07±0.66) points. The observation group had both better postpartum hemorrhage rate and neonatal Apgar score than the control group, and their difference had statistical significance (P<0.05). Conclusion Implement of humanized nursing in puerpera with preterm premature rupture of membranes can reduce their postpartum hemorrhage rate and improve neonatal Apgar score. This method is worthy of clinical promotion.

  20. Antibioticoprofilaxia com ampicilina na rotura prematura das membranas: estudo randomizado e duplo cego Ampicillin prophylaxis in premature rupture of membranes: randomized and double-blind study

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    José Elias Soares da Rocha

    1999-06-01

    avoid or reduce maternal and perinatal infectious morbidity caused by premature rupture of membranes (PROM, and to extend the gestation period in those women. Methods: this was a prospective, randomized and double-blind study, carried out evaluating 121 pregnant women with PROM, randomized into two study groups. The treatment group (61 patients received ampicillin and the control group (60 patients received placebo. The placebo had the same characteristics as ampicillin (kind of packaging and color of the capsules and was used in the same time regimen. The considered parameters for maternal infection were febrile morbidity (fever index, and the presence of chorioamnionitis and/or endometritis. The studied neonatal parameters were Apgar score (1st and 5th minutes, bacterial colonization of auditory canal, and blood culture. The statistical tests performed were Fisher's exact test, Wilcoxon, and chi². Results: it was observed that ampicillin did not prolong the gestation, nor did it reduce the postpartum febrile morbidity or the rates of chorioamnionitis and/or endometritis. Ampicillin did not reduce the perinatal infectious morbidity nor improve the birth outcomes. All these results were consistent in cases of less than 72 h PROM. The limited number of cases with time of PROM greater than 72 h did not permit statistical analysis free of type II error. Conclusions: based on these results it was possible to conclude that the prophylactic use of ampicillin by pregnant women with less than 72 h PROM did not reduce either infectious maternal or perinatal morbidity. However, the presence of group B Streptococcus agalactiae in the blood culture from a neonate in the control group showed the necessity to start antibiotic treatment of pregnant women colonized by this microorganism.

  1. 胎膜早破对新生儿健康危害的研究%Influence of premature rupture of membranes on neonatal health

    Institute of Scientific and Technical Information of China (English)

    吴静; 刘敬; 封志纯; 黄俊锦; 吴刚

    2009-01-01

    Objective To observe the influence of premature rupture of membranes (PROM) on neonatal health. Method A retrospective cohort study was conducted among 3320 in-patient newborns of Bayi Children's Hospital from October 2006 to March 2008. One hundred term newborns and one hundred preterm newborns with PROM were chosen to be compared with fifty normal term newborns and preterm newborns respectively. The data were analyzed with Minitab 12.0 software. Result Of the 3320 newborns, 711(21.4%) were complicated with PROM. The morbidity of PROM was 21.4% (711/3320), among whom 9.69%(196/2022) were term newborns, 39.68%(515/1298) were preterm newborns, the differences between the term and the preterm newborns were statistically significant (P0.05). Total serum bilirubin level of 37.1% of total preterm newborns with PROM exceeded 220 μmol/L, while it was 29.1% in term newborns with PROM (P<0.05). There was a significant decrease of blood platelet count(P<0.01) between the PROM group and the normal group. The myocardial enzymes including lactate dchydrogenisos, aspartate aminotransferase, creatine kinase, MB isoenzyme of creatinc kinase of PROM group were significantly higher than those of the normal group (P<0.05). Compared with the normal group, the average hospital stay of term newborns with PROM and preterm newborns with PROM were prolonged by 20.0% and 25.1% respectively, the average cost of hospitalization of them were increased 30.5% and 60.0% respectively. Conclusion PROM is harmful to newborns health in many ways. Studies on PROM should be enhanced.%目的 探讨胎膜早破(PROM)对新生儿健康的影响.方法 对我院3320例住院新生儿资料进行回顾性分析,其中PROM患儿711例.用系统抽样法随机选取各100例足月PROM及未足月PROM患儿,与正常新生儿进行对照分析.结果 25%(178/711)PROM患儿发生各种感染性疾病,其中肺炎与败血症占87.1%(155/178),主要为感染性肺炎(92/711,12.9%)和败血症(63/711,8.9%).

  2. Expressão local do fator de necrose tumoral alfa na ruptura prematura de membranas Local expression of tumor necrosis factor-alpha on premature rupture of membranes

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    Valquíria Roveran

    2009-05-01

    Full Text Available OBJETIVO: comparar a expressão do fator de necrose tumoral alfa (TNF-α em membranas ovulares com ruptura prematura (RPM e com ruptura oportuna das mesmas; verificar a associação entre a expressão do TNF-α em membranas ovulares e o grau de corioamnionite das mesmas e correlacionar a expressão do TNF-α e o tempo de ruptura das membranas. MÉTODOS: foram analisadas as membranas ovulares de 31 parturientes com RPM, com idade gestacional acima de 34 semanas, e de 14 parturientes com ruptura oportuna das membranas, com idade gestacional igual ou maior de 37 semanas. A detecção da corioamnionite foi feita por meio de estudo histopatológico. A avaliação da expressão do TNF-α foi feita por meio de técnica imunoistoquímica, na qual foi empregado o método streptavidina-biotina-peroxidase (LSAB. RESULTADOS: o tempo médio de ruptura foi de 16,6 horas. A frequência da expressão de TNF-α, nos Grupos Controle e Estudo, não mostrou diferença significante (χ2=6,6; p=0,08. No Grupo Estudo, houve correlação entre o grau de corioamnionite e a intensidade da expressão de TNF-α (coeficiente de Spearman (Rs=0,4; p=0,02. CONCLUSÕES: não houve diferença significante entre as expressões do TNF-α em membranas ovulares com ruptura prematura e com ruptura oportuna das mesmas; no Grupo Estudo, constatou-se associação significante entre a expressão do TNF-α e o grau de corioamnionite e não houve associação entre o tempo de ruptura e a intensidade da expressão do TNF-α.PURPOSE: to compare the expression of tumor necrosis factor-alpha (TNF-α in ovular membranes with premature rupture (MPR and with opportune rupture; to verify the association between the expression of the TNF-α in ovular membranes and the degree of chorioamnionitis, correlating the expression of the TNF-α and the membranes' time of rupture. METHODS: ovular membranes from 31 parturients with MPR, with gestational ages over 34 weeks, and from parturients with opportune

  3. The Prospective Study of Preterm Premature Rupture of Membrane Treatment Strategies%足月胎膜早破临床处理策略的前瞻性研究

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    段碧蓉

    2013-01-01

    目的:进一步研究和探讨临床处理足月胎膜早破时间过程中的有效处理策略,从而为临床的相关实践提供指导依据。方法:选取本院2010年12月-2012年12月分娩的156例足月胎膜早破产妇为研究对象进行了前瞻性研究。结果:(1)两组产妇母体并发症发生情况比较:产后出血发生率、宫内感染发生率和产褥病发生率组间比较,期待治疗组产妇均显著高于引产组产妇水平,差异具有统计学意义(P<0.05);(2)两组新生儿情况比较:围产儿患病率组间比较,期待治疗组新生儿显著高于引产组新生儿水平,差异具有统计学意义(P<0.05)。两组新生儿均无死亡病例发生。结论:在针对足月胎膜早破实施处理的临床实践过程中,采用尽快引产的主动处理方式与采用等待自然分娩的被动处理方式相比较,其临床效果显著,实施主动处理策略后,在很大程度上降低了产妇和新生儿的并发症发生率,是临床处理足月胎膜早破的可靠选择。%Objective:To further study and explore the clinical management of preterm premature rupture of membranes in the process of effective management strategies in time,so as to provide guidance for clinical practice.Method:156 full-term premature rupture of the membranes in our hospital from December 2010 to December 2012 during labor and delivery were chosen as the research object and taken for study. Result:(1)The situations of the two groups of maternal maternal complications compared results were as follows:the incidence of postpartum hemorrhage,intrauterine infection group and the incidence of puerperal disease compared between the two groups,the expectant treatment groups was significantly higher than that of the level of maternal labor group,the difference was with statistical significance(P<0.05);(2)The situations of the two neonates compared results were as follows:the perinatal morbidity

  4. Repercussões maternas e perinatais da ruptura prematura das membranas até a 26ª semana gestacional Maternal and perinatal outcomes of premature rupture of the membranes up to the 26th week of gestation

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    Alessandra Maria Mont'Alverne Pierre

    2003-03-01

    Full Text Available OBJETIVO: avaliar o prognóstico materno e perinatal em casos com amniorrexe prematura ocorridas até a 26ª semana de gravidez. MÉTODOS: análise retrospectiva dos casos de ruptura prematura das membranas ocorridas até a 26ª semana gestacional, sem sinais de trabalho de parto, sem qualquer tratamento para esta condição antes da admissão, acompanhados no período de janeiro de 1994 a dezembro de 1999. Os casos com idade gestacional menor que 22 semanas e peso ao nascimento inferior a 500 gramas foram excluídos. A amniorrexe foi confirmada pelo exame especular. Em caso de dúvida realizaram-se o teste da cristalização e a determinação do pH. Todas as grávidas foram submetidas a exame ultra-sonográfico para determinação da idade gestacional e índice de líquido amniótico. Os dados referentes ao resultado final da gravidez e as conseqüências para mãe, feto e neonato foram tabulados. RESULTADOS: preencheram os critérios de inclusão 29 casos de amniorrexe prematura. A ruptura ocorreu entre a 17ª e a 26ª semana, com média de 23,6 semanas. A duração média do período de latência foi de 21,7 dias. Ocorreram 22 partos vaginais espontâneos e três induzidos, além de quatro cesarianas. Houve sinais de infecção antes do parto em seis casos. Em 37,9% dos casos foram administrados antibióticos e em 6,9%, corticóides. Nenhuma paciente foi submetida a tocólise. Ocorreram três óbitos fetais e 25 neonatais. Apenas um recém-nascido sobreviveu, tendo permanecido na unidade de neonatologia por 19 dias devido a infecção e síndrome do desconforto respiratório. Não ocorreram óbitos maternos. CONCLUSÃO: a amniorrexe prematura até a 26ª semana gestacional tem sido doença com prognóstico extremamente sombrio para fetos e neonatos em nossa instituição.PURPOSE: to evaluate maternal and perinatal outcomes of premature rupture of membranes up to the 26th week of gestation. METHODS: retrospective analysis of the cases of

  5. 臀部充气装置用于胎膜早破孕妇的临床研究%Hip inflatable devices for clinical study of pregnant women, premature rupture of membranes

    Institute of Scientific and Technical Information of China (English)

    孙芹

    2010-01-01

    Objective To investigate the clinical effect of the buttocks inflatable devices for the clinical effects of pregnant women,premature rupture of membranes.Methods 180 patients with premature rupture of membranes in pregnant women,92 cases were randomly divided into two groups,control group 88 cases,the observation group of pregnant women with elevated hip hip inflatable devices to reduce the outflow of amniotic fluid;control group was the first low-pin-high,elevation end of the bed 15°~30°,in order to reduce the outflow of amniotic fluid.Results The group of pregnant women lying in comfort,amniotic fluid volume compared with the control group was statistically significant(P<0.05),the observation group cesarean section,cis-middle class and the delivery rate compared with the control group difference was statistically significant(P<0.01),the two groups in the premature delivery,fetal distress Palace,neonatal asphyxia had a statistically significant (P<0.05),but no statistical significance in puerperal infection rates.Conclusion The hip inflatable devices for pregnant women,a significant effect of premature rupture of membranes,it is worth in obstetric clinical application.%目的 探讨臀部充气装置用于胎膜早破孕妇的临床效果.方法 将180例胎膜早破的孕妇随机分为观察组92例,对照组88例,观察组采用臀部充气装置抬高孕妇臀部,减少羊水流出;对照组采用头低脚高位,抬高床尾15°~30°,以减少羊水流出.结果 观察组孕妇卧位的舒适度、羊水流出量与对照组相比有统计学意义(P<0.05),观察组剖宫产、顺产及助产率与对照组比较差异有统计学意义(P<0.01),两组在早产、胎儿宫窘迫、新生儿窒息方面有统计学意义(P<0.05),但在产褥感染率方面无统计学意义.结论 臀部充气装置用于胎膜早破孕妇有显著效果,值得在产科临床应用.

  6. Colonização bacteriana do canal cervical em gestantes com trabalho de parto prematuro ou ruptura prematura de membranas Cervical bacterial colonization in women with preterm labor or premature rupture of membranes

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    Giuliane Jesus Lajos

    2008-08-01

    Full Text Available OBJETIVO: estudar a colonização bacteriana do canal cervical em gestantes com trabalho de parto prematuro ou com ruptura prematura de membranas. MÉTODOS: foram avaliadas 212 gestantes com trabalho de parto prematuro ou ruptura prematura de membranas. Na admissão hospitalar foram coletadas duas amostras do conteúdo endocervical e realizadas bacterioscopia e cultura em meios ágar sangue e ágar chocolate. Foram analisadas associações da colonização endocervical com infecção do trato urinário materno, corioamnionite, utilização de antibióticos, sofrimento fetal, prematuridade e infecção e óbito neonatais. RESULTADOS: a prevalência de colonização endocervical foi 14,2% (IC95%=9,5-18,9%, com resultados similares entre os casos com trabalho de parto prematuro ou ruptura prematura de membranas. O microorganismo mais prevalente na população estudada foi o estreptococo do grupo B (9,4%, sendo também isolados Candida sp, Streptococcus sp, Streptococcus pneumoniae, Escherichia coli e Enterococcus sp. Das bacterioscopias analisadas, os achados mais freqüentes foram baixa prevalência de bacilos de Döderlein e elevado número de leucócitos. Em mulheres colonizadas, houve maior prevalência de infecção do trato urinário (23,8 versus 5,4%; pPURPOSE: to study cervical colonization in women with preterm labor or premature rupture of membranes. METHODS: two hundred and twelve pregnant women with preterm labor or premature rupture of membranes were studied. Two cervical samples from each woman were collected and bacterioscopy and culture were performed. Association of cervical microorganisms and urinary tract infection, chorioamnionitis, fetal stress, antibiotic use, prematurity, neonatal infection, and neonatal death were evaluated. RESULTS: the prevalence of endocervical colonization was 14.2% (CI95%=9.5-18.9%, with similar results in preterm labor or premature rupture of membranes. Group B streptococcus was the most prevalent

  7. Premature Contractions

    Science.gov (United States)

    ... Peripheral Artery Disease Venous Thromboembolism Aortic Aneurysm More Premature Contractions - PACs and PVCs Updated:Dec 15,2016 ... You felt this more-forceful beat. Types of premature contractions Premature atrial contractions (PACs) start in the ...

  8. 下生殖道感染对胎膜早破及母婴结局影响的临床分析%Clinical analysis of lower genital tract infection on premature rupture of membranes and maternal and child outcomes

    Institute of Scientific and Technical Information of China (English)

    戴婵娟; 华莹

    2015-01-01

    目的:探讨下生殖道感染对胎膜早破及母婴结局的影响。方法选择胎膜早破孕妇413例为研究组。根据是否足月分为足月亚组和未足月亚组。同时选择无胎膜早破孕妇420例为对照组。对所有纳入研究的的对象宫颈分泌物检测衣原体、支原体,阴道分泌物检测假似酵母菌、细菌检测、滴虫,并取胎膜进行病理学检查,分析下生殖道感染对胎膜早破及母婴结局的影响。结果胎膜早破组发生支原体感染、衣原体感染、细菌性阴道病、假丝酵母菌、滴虫感染率显著高于未胎膜早破组(P<0.01或P<0.05)。胎膜早破孕妇,未足月亚组支原体、衣原体、细菌性阴道病、假丝酵母菌、滴虫感染率显著高于足月亚组(P<0.01或P<0.05)。下生殖道感染孕妇早产、产褥感染、绒毛膜羊膜炎、新生热肺炎发生率显著高于未感染孕妇(P<0.01);胎膜早破组早产、产褥感染、绒毛膜羊膜炎、新生热肺炎发生率显著高于未胎膜早破组(P<0.01)。结论下生殖道感染增加胎膜早破几率,也是导致母婴不良结局重要因素。%Objective To study effect of lower genital tract infection on premature rupture of membranes and maternal and child outcomes. Methods Selected 413 cases with lower genital tract infection on premature rupture of membranes and maternal and child outcomes were divided into term subgroup and preterm subgroup. Selected 420 cases without premature rupture of membranes as control group. Cervical secretions were collected to detect Chlamydia and My-coplasma, and vaginal secretions were collected to detect candida yeast, bacteria and trichomoniasis. Membranes were collected for pathological examination. Effect of lower genital tract infection on premature rupture of membranes and maternal and child outcomes was analyzed. Results Mycoplasma infection, chlamydia infection, bacterial vaginosis,candida, trichomonas infection rates of

  9. 孕妇牙周病与胎膜早破的相关性研究%Associativity Study between Periodontitis and Premature Rupture of Membrane in Pregnant Women

    Institute of Scientific and Technical Information of China (English)

    程敏; 杨丽丽; 许为; 陈琛

    2012-01-01

    目的:本研究通过检查比较胎膜早破孕妇与正常孕妇牙周健康状况,分析牙周健康状况与胎膜早破的关系,为胎膜早破的病因提供一定的临床依据.方法:选择早产胎膜早破(PPROM)孕妇18例、足月胎膜早破(PROM)孕妇20例作为实验组,足月正常孕妇(Non- PROM) 28例作为对照组.检查牙周状况记录菌斑指数(PLI)、探诊深度(PD)和龈沟出血指数(SBI).结果:胎膜早破组牙龈炎症明显,牙周状况差,PLI、SBI均高于正常对照组,差异有统计学意义(P<0.05).各组间探诊深度无明显差别,无统计学意义.结论:牙周病可能是导致胎膜早破的原因之一.孕期及孕前的口腔保健及口腔健康教育,是预防和减少不良妊娠结局发生的有效措施.%Objective: By comparing premature rupture of membranes of pregnant women with normal pregnant women about periodontal health, to analyze the relationship between periodontal condition and premature rupture of membrane (PROM) in order to provide basis to keep pregnant women from oral diseases. Methods: 18 cages of pre-term pregnant women with PROM (Group PPROM) and 20 cases of full term pregnant women with PROM (Group PROM) were selected as the study group, and 28 cases of full term normal pregnant women (Non-PROM) were selected as the control group. Everyone's plaque index (PLI), probing depth (PD) and sulcular bleeding index (SBI) were checked and recorded. Results: The pregnant women with PROM (Group PPROM and Group PROM) had clear gingival inflammation, and bad periodontal conditions. The expression of PLI and SBI in the study group were higher than that in the control group. There was statistical difference of PLI and SBI between the study group and the control group (P<0. 05). There was no significant difference of PD among PPROM, PROM and Non-PROM. Conclusion: Periodontal disease may be one of the reasons that cause premature rupture of membrane. Oral health and oral health education before and

  10. The pregnancy outcomes of preterm premature rupture of membranes prior to 34 weeks's gestation in 128 women%孕34周前胎膜早破128例妊娠结局分析

    Institute of Scientific and Technical Information of China (English)

    李勤; 刘正平; 秦竞霞

    2010-01-01

    目的 探讨孕34周前发生胎膜早破者期待治疗的妊娠结局.方法 选择2008年1月-2009年12月我院住院分娩的未足月胎膜早破(PPROM)孕妇128例.根据胎膜破裂时孕周将孕妇分为两组,其中孕周28~31+6周为组Ⅰ,共52例;孕周32~33+6周为组Ⅱ,共76例.对两组的妊娠结局进行分析.结果 组Ⅰ新生儿窒息、新生儿呼吸窘迫综合症(NRDS)、新生儿缺血缺氧性脑病(HIE)、颅内出血、围产儿死亡率高于组Ⅱ,差异有统计学意义(P0.05).结论 PPROM是围产儿发病和死亡的主要原因;胎龄越小、死亡率越高.在临床工作中应提高PPROM的预防、诊断及治疗水平,从而提高产科治疗质量,降低围产儿病率.%Objective To explore the pregnancy outcomes of preterm premature rupture of membranes (PPROM) prior to 34 weeks' gestation. Methods 128 women with PPROM who had experienced labor in our hosptial during the period of January 2008 to December 2009 were assigned to group with 28 to 31 week's gestation (52 women, group Ⅰ)or group with 32 to 34 week's gestation (76women, group Ⅱ) based on their gestational age. The pregnancy outcomes were analyed in the two groups.Results The incidences of neonatal asphyxia, neonatal respiratory distress syndrome, neonatal hypoxic-ischemicencephalopathy, intracranial hemorrhages, and perinatal death were significantly higher in group Ⅰ than in group Ⅱ (P 0.05). Conclusions Preterm premature rupture of membranes is a primary cause of perinatal diseases and death. The shorter the gestational age, the higher the perinatal death rate. The quality of obstetric care can be improved and the perinatal morbidity can be reduced by elevating the level of prevention, diagnosis, and treatment.

  11. 不同孕周未足月胎膜早破期待治疗的临床观察%Comparison of Pregnancy Outcomes of Expectation Treatment on Preterm Premature Rupture of the Membraneof Different Gestational Weeks

    Institute of Scientific and Technical Information of China (English)

    王玲

    2013-01-01

    Objective To compare the expectation treatment effectiveness on preterm premature rupture of the membrane of different gestational weeks, and explore the suitable time of termination of pregnancy. Methods Expectation treatment were given to the patients of pregnancy of 0.05 ). Conclusion Implementation of expectation treatment among preterm premature rupture of the membrane of( 32 -33 +6 )gestational weeks can improve the pregnancy outcome. Therefore,under the maternal and fetal condition's permission, expectation treatment should be implemented to prolong pregnancy time as long as possible.%目的 比较不同孕周未足月胎膜早破患者期待治疗后的临床效果,探讨未足月胎膜早破适宜终止妊娠的时机.方法 对入院时孕<31+6周(A组,40例)、孕32 ~33+6周(B组,46例)以及孕34 ~36+6周患者(C组,44例)实施期待疗法,比较期待治疗时间,母体感染率及围生儿结局的差异.采用WHCIEP16.0医学统计学软件进行数据分析.结果 B组延长孕周时间>A组、C组(P<0.05).A组新生儿体质量低于B组、C组,A组的母体感染率、新生儿呼吸窘迫综合征(NRDS)发生率以及围生儿死亡率均高于B组、C组(P<0.05).B、C两组相比差异无统计学意义(P>0.05).结论 孕32 ~33+6周未足月胎膜早破者实施期待治疗可以改善妊娠结局,故在母体与胎儿病情允许的情况下,尽可能实施期待治疗以延长妊娠时间.

  12. 足月胎膜早破先露衔接对剖宫产指征的影响%Study of the cesarean section indications of fetal presentation engagement in primipara with full-term premature rupture of membrane

    Institute of Scientific and Technical Information of China (English)

    滕奔琦; 范建辉; 侯红瑛

    2011-01-01

    Objective To explore the cesarean section indications of fetal presentation unengagement in primipara with full-term premature rupture of membrane. Methods Five hundreds and ten primipara with premature rupture of membrane at term were divided into 2 groups: the fetal head was not engaged in the birthing process ( study group 218 cases) and engaged in the birthing process( control group 292 cases). The delivery course and the incidence of complication of the mother and infant were compared between 2 groups. The main outcome measure was the rate of caesarean section, indications of cesarean section, the cervical maturity(by Bishop scoring), the rate of fetal distress and newborn asphyxia, et al. Results The rate of cesarean section was higher in study group (64.7%) than that in control group( 17.5% ) ( P <0.01 ), so were the rate of fetal distress, stagnant labor and of failure of induction( P <0.05 ). In the cases of study group, the cervical condition of easy delivery ones was better than that of caesarean section ones. Average neonatal weight of easy delivery ones is lighter than caesarean section ones. Conclusions When the fetal head is not engaged in the birthing process in primipara with premature rupture of membrane at term, the labor induction is difficult. The labor complications are common, and the rate of caesarean section is high because of the loss of amniotic fluid and the poor cervical condition. Primipara at term whose presentation is not engaged in the birthing process should try to avoid premature rupture of membrane. Cervical ripening and induction should be done as soon as possible after membrane rupture.%目的 探讨胎膜早破患者的胎先露衔接情况对剖宫产指征的影响.方法 选择我院2008年4月至2009年4月足月妊娠(孕37~41+6周)分娩的510例胎膜早破初产妇.根据先露衔接与否分为未衔接组(218例)和衔接组(292例).对2组分娩方式、剖宫产指征、宫颈Bishop

  13. Premature infant

    Science.gov (United States)

    There are many support groups for parents of premature babies. Ask the social worker in the neonatal intensive care unit. ... Prematurity used to be a major cause of infant deaths. Improved ... Prematurity can have long-term effects. Many premature infants ...

  14. 不同分娩方式对未足月胎膜早破的早产儿预后影响%The Prognosis Influence of Different Delivery Japes on Premature Infant with Preterm Premature Rupture of Membrane

    Institute of Scientific and Technical Information of China (English)

    贾晓婕

    2011-01-01

    Objective: To explore the prognosis influence of different delivery taps on premature infant with PPROM.Methods:75 cases of puerpera with PPROM were divided into cesarean section group(n=43) and eutocia group(n=32).The related indexes of new-born were analyzed,then.Results:The death rate in experimental group was 7.0%,the infection rate was 25.6%,and the data in eutocia group was 18.8% and 37.5%.The clinical effect in experimental group was significantly better than that in control group (P<0.05).Conclusions:For better prognosis,it should according to concrete situation to choose right delivery tape,and give right treatment for new-born.%目的:探讨不同分娩方式对未足月胎膜早破的早产儿预后影响.方法:将75例胎膜早破早产孕妇根据具体情况分为剖宫产组(n=43)和顺产组(n=32),对新生儿相关指标进行分析.结果:剖宫产组死亡率为7.0%,并发症率为25.6%,顺产组死亡率为18.8%,并发症率为37.5%,两组相比具有显著性差异(P<0.05).结论:应根据产妇的具体情况,选择合适的分娩方式,并对新生儿给予妥当处理,以达到最佳的预后效果.

  15. Phosphatidylglycerol determination in the amniotic fluid from a PAD placed over the vulva: a method for diagnosis of fetal lung maturity in cases of premature ruptured membranes.

    Science.gov (United States)

    Estol, P C; Poseiro, J J; Schwarcz, R

    1992-01-01

    Four hundred and forty seven pregnant women with ruptured membranes, were prospectively studied in order to assess the diagnostic capacity of Phosphatidylglycerol (PhG) determination in amniotic fluid recovered from vulval pads in the diagnosis of Hyaline Membrane Disease (HMD). The identification of PhG was performed using one dimensional silica gel thin layer chromatography. The sensitivity of PhG determination in the diagnosis of HMD in newborns of the total population was found to be 88.2%, with a specificity of 76.9%. In the study population, the incidence of HMD was 7.6%, the negative predictive value was 98.8% and, the positive predictive value was 24.0%. When the 265 newborns of the gestational age group of less than or equal to 34 weeks is considered, we observed an incidence of HMD of 12.1%. The diagnostic capacity of PhG in this group was shown by a sensitivity of 87.5%, a specificity of 76.4%, a positive predictive value of 33.7% and a negative predictive value of 97.8%. This method of assessment of fetal lung maturity has a diagnostic capability similar to that described by other authors, who used amniotic fluid obtained vaginally or transabdominally. The procedure described here of amniotic fluid collection is non-invasive, harmless to the mother and fetus and simple to perform. The characteristics of this method, allow serial studies of the amniotic fluid to be carried out.

  16. Is Preterm Premature Rupture of Membranes Latency Influenced by Single Versus Multiple Agent Antibiotic Prophylaxis in Group B Streptococcus Positive Women Delivering Preterm?

    Science.gov (United States)

    Smith, Anita; Allen, Victoria M; Walsh, Jennifer; Jangaard, Krista; O'Connell, Colleen M

    2015-09-01

    Objectif : Évaluer l’influence d’un schéma antibiotique sur la durée de la latence (période séparant la rupture prématurée des membranes préterme [RPMP] et l’accouchement) et la présence d’une morbidité infectieuse néonatale considérable, entre la rupture des membranes et l’accouchement à logistique a été utilisée pour estimer les rapports de cotes corrigés, les intervalles de confiance à 95 % et les différences moyennes pour toutes les issues et pour tenir compte des variables parasites. Résultats : Entre 1988 et 2011, la population d’étude potentielle s’élevait à 119 158 grossesses. Au total, 3 435 accouchements ont été identifiés comme présentant une RPMP (3 %). La présence de SGB avait été déterminée par uroculture ou par mise en culture d’écouvillonnages chez 303 paires mère-enfant (9 %) de ce groupe. Les comparaisons corrigées de la latence et de la septicémie néonatale n’ont indiqué aucune différence en fonction du schéma antibiotique (P > 0,05). Conclusion : La directive de 2013 de la SOGC sur la prophylaxie anti-SGB recommande la mise en œuvre d’une antibiothérapie chez les femmes qui présentent une RPMP, et ce, tant pour la latence que pour la prévention de la septicémie néonatale attribuable aux SGB. Cette évaluation pertinente sur le plan clinique auprès d’un groupe sélectionné d’accouchements prétermes a démontré que le type de schéma antibiotique n’influençait ni la latence (en présence d’une RPMP et de résultats positifs à la suite de la mise en culture des SGB) ni les taux de septicémie néonatale. La poursuite de l’évaluation des issues néonatales graves s’avère essentielle à la lumière de cette nouvelle recommandation.

  17. Morbidade Materna e Morbimortalidade Perinatal Associada à Infecção Ascendente na Rotura Prematura das Membranas Maternal Morbidity and Perinatal Morbidity and Mortality Associated with Ascendant Infection in Premature Rupture of Membranes

    Directory of Open Access Journals (Sweden)

    José Elias Soares da Rocha

    2002-01-01

    Full Text Available Objetivo: avaliar as repercussões da infecção ascendente sobre a mãe, o feto e o recém-nascido (RN nos casos de rotura prematura das membranas (RPM. Métodos: estudo prospectivo, avaliando 50 gestantes portadoras de RPM e seus RN. A corioamnionite clínica foi rastreada por meio de critérios clínicos (curva térmica, dor abdominal à palpação e/ou amolecimento uterino, odor e características da secreção vaginal e subsidiários (leucograma e proteína C reativa. Por sua vez, a corioamnionite histológica foi avaliada com estudo macroscópico e microscópico da placenta, membranas e cordão umbilical. No estudo microscópico, utilizou-se a microscopia óptica com coloração pela hematoxilina-eosina. Os RN foram avaliados pela mensuração do peso e índice de Apgar no 1o e 5o minuto. O leucograma e a cultura do material colhido do ouvido e aspirado gástrico complementaram o estudo. Para análise estatística foram utilizados os testes exato de Fisher e t de Student, com nível de significância de 5% (pPurpose: to evaluate the effects of ascending infection on the mother and newborn in the cases of premature rupture of membranes. Methods: this was a prospective study, carried out to evaluate 50 pregnant women with premature rupture of membranes (PROM and their newborns. The clinical chorioamnionitis was investigated by clinical findings (thermal curve, abdominal pain by groping and/or uterine softening, smell and other characteristics of vaginal secretion and subsidiary tests (white blood cell count and C-reactive protein. The histologic chorioamnionitis was investigated by macroscopic and microscopic study (placenta, membranes and cord. In the microscopic study optic microscopy with hematoxylin-eosin staining was used. The newborns were evaluated as to weight and Apgar score in the first and fifth minutes of life. White blood cell count, culture of auditory canal swab and aspirated gastric material culture complemented the study

  18. Premature ejaculation

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/001524.htm Premature ejaculation To use the sharing features on this page, please enable JavaScript. Premature ejaculation is when a man has an orgasm ...

  19. Preterm labor and preterm premature rupture of membranes have a different pattern in the involved compartments of acute histologoic chorioamnionitis and/or funisitis: Patho-physiologic implication related to different clinical manifestations.

    Science.gov (United States)

    Park, Chan-Wook; Park, Joong Shin; Moon, Kyung Chul; Jun, Jong Kwan; Yoon, Bo Hyun

    2016-06-01

    It is unknown whether histo-topographic findings about the involved compartments (i.e., choriodecidua, amnion, chorionic-plate) of acute-histologic chorioamnionitis (acute-HCA) and/or funisitis according to the presence or absence of intra-amniotic inflammation (IAI) and/or fetal inflammatory response syndrome (FIRS) are different between preterm labor and intact membranes (PTL) and preterm premature rupture of membranes (preterm-PROM). The involved compartments of acute-HCA and/or funisitis were examined in 161 singleton preterm-births (preterm-PROM (n = 73). The study-population was divided into IAI(-)/FIRS(-), IAI(+)/FIRS(-), and IAI(+)/FIRS(+) groups according to the presence or absence of IAI (amniotic-fluid MMP-8 ≥ 23 ng/ml) and/or FIRS (umbilical-cord plasma CRP ≥ 200 ng/ml). Histological inflammation was not detected in any-compartment except choriodecidua in IAI(-)/FIRS(-) group with PTL while inflammation appeared in all-compartment0s (choriodeciduitis-46.2 %; amnionitis-23.1 %; funisitis-30.8 %; chorionic-plate inflammation-7.7 %) in IAI(-)/FIRS(-) group with preterm-PROM. IAI(+)/FIRS(-) group had a significantly higher frequency of inflammation in each-compartment than IAI(-)/FIRS(-) group in PTL (each-for P preterm-PROM (each-for P > 0.1). However, IAI(+)/FIRS(+) group had a significantly higher rate of inflammation in each compartment than IAI(+)/FIRS(-) group in both PTL and preterm-PROM (each-for P preterm-PROM had a different pattern in the involved compartments of acute-HCA and/or funisitis in the IAI(-)/FIRS(--) group and in the change of involved compartments from IAI(-)/FIRS(-) to IAI(+)/FIRS(-).

  20. 妊娠36周及以上胎膜早破时抗生素的应用分析%An analysis of application antibiotics in premature rupture of membrane at and above 36 weeks of gestation

    Institute of Scientific and Technical Information of China (English)

    谭雅青; 覃慧瑛; 蓝凤萍

    2016-01-01

    Objective To explore the influence of antibiotics on maternal-infant outcome in premature rupture of mem-brane at and above 36 weeks of gestation.Methods 84 patients with premature rupture of membrane admitted to hospital from October,2013 to November,2014 were divided into control group(41 cases)and observation group(43 cases).The con-trol group was given sodium intravenous drip of antibiotics to prevent infection,and the observation group were not given anti-biotics.Maternal-infant outcomes like cesarean section,puerperal infection,chorioamnionitis,postpartum hemorrhage and fetal distress,neonatal aspiration pneumonia,neonatal asphyxia and perinatal death,etc.of the two groups were compared.Mean-while,abnormal condition of normal indexes like postpartum body temperature,C-reactive protein(CRP),blood routine and perineum wound infection,etc.were observed between groups.Results Difference of incidence of cesarean section,postpar-tum hemorrhage,fetal distress,neonatal aspiration pneumonia and neonatal asphyxia of the observation group and the control group was not statistically significant(P>0.05).No puerperal infection,chorioamnionitis and perinatal death were found in neither groups.There was no statistically significant difference in abnormal postpartum body temperature,abnormal CRP,ab-normal blood routine and abnormal perineum wound infection in the two groups(P>0.05).Conclusion In the absence of clear cases of infection,there is no effect of the use of antibiotics on the delivery mode and the incidence of maternal and in-fant complications in the 36 weeks of pregnancy or above and the premature rupture of membranes.%目的:探讨妊娠36周及以上胎膜早破时使用抗生素对母婴结局的影响。方法将2013年10月至2014年11月收治的84例胎膜早破患者随机分为两组,对照组41例给予头孢菌素类抗生素静脉滴注预防感染,观察组43例未给予抗生素治疗,比较两组剖宫产、产褥感染、产妇绒毛膜炎

  1. 不同孕周胎膜早破对妊娠结局的影响及治疗%Effects and treatment of different gestational weeks on pregnancy outcomes in premature rupture of membranes

    Institute of Scientific and Technical Information of China (English)

    郭帆; 周敏

    2014-01-01

    Objective To study the effects and treatment of different gestational weeks and latent period on pregnancy in premature rupture of membranes(PROM). Methods The clinical data from 120 gravidas between 28-36+6 weeks with PROM and neonata information were retrospectively analyzed. Results Transient respiratory hypoxia ischemic encephalopathy(HIE) and death as well as the chorioamnionitis were higher in 28-35 weeks of PROM than those in 35+1-36+6 weeks of PROM. In 28-35 eeks of PROM, transient respiratory distress, HIE and death of the newborn were higher in group of latent period within 12h than that in group of latent period over 12h.there was statistic difference (P<0.05).In 35+1-36+6 weeks of PROM, there was no statistic difference of maternal complication incidences between the different latent period. Conclusion The suitable measures to treat the patients with PROM at 28-35 gestational weeks are promoting fetal lung maturation, preventing infection, extending the gestational week and termination the pregnancy at the right time, while to the patients with PROM at 35+1-36+6 gestational week with maturation of fetal lung it should terminate the pregnancy within 12h after the rupture of membrane.%目的:探讨不同孕周胎膜早破(PROM)及不同潜伏期对妊娠结局的影响及治疗。方法回顾性分析120例孕28~36+6周PROM孕产妇和新生儿的临床资料。结果孕28~35周PROM组新生儿呼吸困难、缺血缺氧性脑病和死亡及绒毛膜炎的发生率均明显高于孕35+1~36+6周PROM组。孕28~35周PROM组潜伏期在12h以内者新生儿呼吸困难、缺血缺氧性脑病和死亡均高于潜伏期在12h以后者,两组比较差异有统计学意义(P<0.05)。孕35+1~36+6周PROM组潜伏期在12h以内者的孕产妇与潜伏期在12h以后者相关并发症发生率差异无统计学意义。结论对孕28~35周PROM应采取促胎肺成熟和预防感染等措施,延长孕周,适时终止妊娠;而孕35+1~36+6

  2. 孕足月胎膜早破残余羊水量与母儿预后的关系%Residue amniotic fluid volume after premature rupture of membranes and maternal-fetal outcome

    Institute of Scientific and Technical Information of China (English)

    桑琳; 吴艳

    2013-01-01

    Objective To determine the relationship between the residue amniotic fluid volume after premature rupture of membranes (PROM) and maternal-fetal prognosis. Methods 162 pregnant women with PROM were studied , hospitalized in department of Obstetrics and Gynecology ,the Affiliated Hefei Hospital of Anhui Medical University from Jun . 2011 to Dec. 2011. According to Amniotic fluid index (AFl)by ultrasound,patients were assigned into three groups :(1)Group of normal amniotic fluid;90 pregnant women(80 mm≤ AFI 0. 05 ). The rupture distance delivery time of three groups had no significant difference (P >0. 05). The puerperal morbidity of three groups had no significant difference (P >0. 05). The Neonatal asphyxia of oligohydramnios group was significantly higher than that of normal amniotic fluid group ( P 0. 05 ). There was no significant difference between borderline oligohydramnios group and oligohydramnios group (P >0. 05). Conclusion Oligohydramnios after prom increase neonatal asphyxia and cesarean section rate . The amniotie fluid volume might be an important prognostic indicator to assess the maternal and neonatal outcomes when PROM happened .%目的 探讨足月胎膜早破残余羊水量与母儿预后关系.方法 采用回顾性研究方法选择该院2011年6-12月162例孕足月胎膜早破病例,根据破膜后残余羊水的羊水指数(AFI)将162例孕妇分成三组,其中羊水指数正常组90例(80 mm≤AFI<180 mm),可疑羊水过少组40例(50 mm≤AFI<80 mm),羊水过少组32例(AFI<50 mm).比较其分娩方式及母儿结局.结果 羊水过少组剖宫产率明显高于羊水指数正常组,差异有统计学意义(P<0.05).可疑羊水过少组与羊水指数正常组相比剖宫产率差异无统计学意义(P>0.05),三组破膜距分娩时间相比差异均无统计学意义(P>0.05),三组产后产褥病率发生率差异均无统计学意义(P>0.05),羊水过少组新生儿窒息率明显高于羊水指数正常

  3. Valores séricos de imunoglobulinas e dos componentes do complemento em gestantes com ruptura prematura de membranas Immunoglobulin serum values and complement components in pregnant women with premature rupture of the membranes

    Directory of Open Access Journals (Sweden)

    Valquíria Roveran

    2007-04-01

    imunoglobulinas e complementos.PURPOSE: the premature rupture of membranes (PROM has been a reason for many investigations, amongst which the involved immune mechanisms. Ahead of the scarcity of studies related to the subject, this work had as objective to evaluate the serum values of IgA, IgG, IgM, C3 and C4 in pregnant women with pre-term PROM. METHODS: in this transversal study, 36 pregnant women had been enclosed, with gestational age between 23 and 37 weeks. Of this total, 15 women had had laboratorial and clinical diagnosis of PROM. Patients with beginning of the childbirth work, clinical signals of infection, clinical dysfunction with systemic repercussion had been excluded. Serum concentrations of immunoglobulin (IgA, immunoglobulin M (IgM and immunoglobulin G (IgG, C3 and C4 had been evaluated in the patients with (study group and without PROM (control group. Correlation among dosages; number of childbirths and time of rupture was determined by Spearman coefficient correlation (r value. RESULTS: serum levels of IgA (average±SD had been significantly higher in the patients of the control group (271.0±107.0 versus 202.9±66.1; respectively, control and study group; p=0.024. There was no statistical difference when the levels of IgM, IgG, C3 and C4 had been compared between two groups. Significant association was not noticed between the number of childbirths and the IgA, IgM, IgG, C3 and C4 dosages (Spearman; r between -0,009 and 0,027; p>0,05. The average time of rupture of study group patients was of 19.1 hours (one - 72 hours, without association with the evaluated serum dosages. CONCLUSIONS: pregnant women with PROM show levels of IgA significantly lower than normal pregnant patients. The variable "number of childbirths" does not act as a factor of confusion in the comparative analysis of the dosages obtained in patients with or without PROM, as well as also it did not have association between the time of rupture and the immunoglobulin and complements serum dosages.

  4. 羊水葡萄糖及白介素-6在胎膜早破中的意义%Determination of Amniotic Fluid Glucose and Interleukin 6in Premature Rupture of Membranes

    Institute of Scientific and Technical Information of China (English)

    陈丽红; 胡继芬; 游彩玲; 马炎辉

    2001-01-01

    Objective To study the relationship between amniotic cavity infection and the content of glucose and interleukin 6(IL 6) in amniotic fluid in premature rupture of membranes(PMOR) group. Methods To chose randomly 70 examples of PMOR patients without pregnant complication in 1994~1999. Leading by Brightness mode of ultrasound, amniotic fluid was obtained by puncturing the amnion through abdomen. Amniotic fluid glucose was determined quantitatively by "Glucose oxidizing enzyme", IL 6 was measured by enzyme linked immunosorbent assay. Results The content of glucose in amniotic fluid decreased obviously while the quantity of IL 6 increased distinctively in the group with PMOR and amniotic cavity infection. When the content of glucose in amniotic fluid was lower than 0.55 mmol/L while the quantity of IL 6 higher than 315 ng/L, the sensitivity of amniotic cavity infection was expected to be 100%, the specificity over 80%. Conclusion In the PMOR group, to determine the content of glucose and IL 6 in amniotic fluid can predict amniotic cavity infection rapidly and conveniently.%目的探讨胎膜早破患者羊水中葡萄糖及白介素 6(IL 6)含量与宫内感染的关系。方法随机选择1994~1999年70例无妊娠并发症的胎膜早破的患者,在B超引导下,经腹行羊膜腔内穿刺,抽取羊水,用葡萄糖氧化酶方法测定羊水中葡萄糖,用酶联免疫方法测定IL 6含量。结果胎膜早破并宫内感染者,羊水葡萄糖含量明显下降,IL 6含量则明显增高,当羊水葡萄糖含量≤0.55 mmol/L,IL 6含量≥315 ng/L时,预测宫内感染的敏感性100%,特异性>80.00%。结论胎膜早破患者,测定羊水葡萄糖及IL 6含量,能早期快速预测宫内感染。

  5. 生物蛋白胶在未足月胎膜早破中的应用%Application of Fibrin Glue (FG) in Preterm Premature Rupture of Membranes

    Institute of Scientific and Technical Information of China (English)

    陈红; 杨军; 唐瑶; 王涛; 廖晓焰; 常林利; 蔡一玲; 李萍

    2009-01-01

    目的:探讨生物蛋白胶封堵宫颈治疗未足月胎膜早破延长孕周的可行性和安全性.方法:收集我院2006年6月至2007年12月妊娠28~32周胎膜早破患者26例分成两组,治疗组13例采用生物蛋白胶封堵宫颈,对照组13例采用期待疗法,比较两组的延长孕周时间及围生儿结局.结果:治疗组无一例发生宫内感染和过敏反应.治疗组总有效率为61.5%,明显高于对照组(15.4%),P<0.05;治疗组较对照组延长孕周时间更长,新生儿死亡率、围生儿并发症发生率更低,两组比较差异有统计学意义(P<0.05).结论:生物蛋白胶应用于未足月胎膜早破可有效延长孕周时间,并且使用安全,无副反应.%Objective:To probe into the feasibility and safety of extending the pregnancy period for pregnant women with preterm premature rupture of membranes(PPROM) by fibrin glue (FG). Methods:An investigation was made of 26 cases of PPROM from Jun 2006 to December 2007 in our Hospital. These 26 PPROM women were divided into two groups: study group treated by FG (13 cases), and expectant group without FG treatment (13 cases) as control. The extension of pregnant period and perinatal result were investigated. Results:There was no intraunterine infection and allergic response in study group. The total effective rate in FG group was 61.5%, higher than control group (15.4%) ( P<0.05); The FG group had a longer pregnant period,lower neonatal death and perinatal complication, when compare to control group ( P < 0.05). Conclusions: Fibrin glue can appropriately extend the pregnant period of women with PPROM.

  6. Timing of Histologic Progression from Chorio-Deciduitis to Chorio-Deciduo-Amnionitis in the Setting of Preterm Labor and Preterm Premature Rupture of Membranes with Sterile Amniotic Fluid.

    Directory of Open Access Journals (Sweden)

    Chan-Wook Park

    Full Text Available Histologic chorio-deciduitis and chorio-deciduo-amnionitis (amnionitis in extra-placental membranes are known to represent the early and advanced stages of ascending intra-uterine infection. However, there are no data in humans about the time required for chorio-deciduitis to develop and for chorio-deciduitis without amnionitis to progress to chorio-deciduitis with amnionitis, and the effect of prolongation of pregnancy on the development of chorio-deciduitis and amnionitis in patients with preterm labor and intact membranes (PTL and preterm premature rupture of membranes (preterm-PROM. We examined these issues in this study.The study population consisted of 289 women who delivered preterm (133 cases with PTL, and 156 cases with preterm-PROM and who had sterile amniotic fluid (AF defined as a negative AF culture and the absence of inflammation as evidenced by a matrix metalloproteinase-8 (MMP-8 level <23 ng/ml. We examined the association between amniocentesis-to-delivery interval and inflammatory status in the extra-placental membranes (i.e., inflammation-free extra-placental membranes, choroi-deciduitis only, and chorio-deciduitis with amnionitis in patients with PTL and preterm-PROM.Amniocentesis-to-delivery interval was longer in cases of chorio-deciduitis with amnionitis than in cases of chorio-deciduitis only in both PTL (median [interquartile-range (IQR]; 645.4 [319.5] vs. 113.9 [526.9] hours; P = 0.005 and preterm-PROM (131.3 [135.4] vs. 95.2 [140.5] hours; P<0.05. Amniocentesis-to-delivery interval was an independent predictor of the development of both chorio-deciduitis and amnionitis after correction for confounding variables such as gestational age at delivery in the setting of PTL, but not preterm-PROM.These data confirm for the first time that, in cases of both PTL and preterm-PROM with sterile AF, more time is required to develop chorio-deciduitis with amnionitis than chorio-deciduitis alone in extra-placental membranes. Moreover

  7. Prelabor Cesarean Section and Risk of Childhood Type 1 Diabetes A Nationwide Register-based Cohort Study

    DEFF Research Database (Denmark)

    Clausen, Tine Dalsgaard; Bergholt, Thomas; Eriksson, Frank;

    2016-01-01

    BACKGROUND: Unfavorable conditions associated with cesarean section may influence the risk of type 1 diabetes in offspring, but results from studies are conflicting. We aimed to evaluate the association between prelabor cesarean section and risk of childhood type 1 diabetes. METHODS: A Danish...... contributed 20,436,684 person-years, during which 4,400 were diagnosed with childhood type 1 diabetes. RESULTS: The hazard ratio for childhood type 1 diabetes was increased in children delivered by prelabor cesarean section compared with vaginal delivery when adjusted for year of birth, parity, sex, parental...... age, and education and paternal type 1 diabetes status at childbirth (HR 1.2; 95% CI 1.0 to 1.3), but not after additional adjustment for maternal type 1 diabetes status at childbirth (HR 1.1; 95% CI 0.95 to 1.2). Delivery by intrapartum cesarean section was not associated with childhood type 1...

  8. 生物蛋白胶宫颈封堵术在未足月胎膜早破中的临床应用%Application of biological fibrin glue closure in pregnant women with preterm premature rupture of membrane

    Institute of Scientific and Technical Information of China (English)

    李小瑜; 傅斌; 黎月仪

    2014-01-01

    Objective To investigate the effectiveness of biological fibrin glue closure in pregnant women with preterm premature rupture of membrane. Methods Twenty-eight cases of pregnant women with preterm prema-ture rupture of membrane from March 2012 to December 2013 in our hospital were selected and divided into three groups randomly. All three groups were treated with biological fibrin glue closure via the cervical intubation with the monitoring of ultrasound (Group A, 10 cases), endoscopy (Group B, 8 cases) and amnioscopy (Group C, 10 cases). To-colytics were applied as following in all groups. And then the effectiveness and differences in delivery were compared. Results In Group A, the cure rate, effective rate and inefficiency rate were 0.0%(0 case), 20.0%(2 cases) and 80.0%(8 cases) respectively, with 2 cases of natural childbirth, 3 cases of operative vaginal delivery and 5 cases of cesarean section, and the fetal survival rate was 60.0%. In Group B, the cure rate, effective rate and inefficiency rate were 25.0%(2 cases), 50.0%(4 cases) and 25.0%(2 cases) respectively, with 1 case of natural childbirth, 1 case of opera-tive vaginal delivery and 3 cases of cesarean section, and the fetal survival rate was 83.3%. And in Group C, the cure rate, effective rate and inefficiency rate were 80.0%(8 cases), 10.0%(1 case) and 10.0%(1 case), with 8 cases of natu-ral childbirth, 1 case of operative vaginal delivery, 1 case of cesarean section, and the fetal survival rate was 100.0%. The total effective rate in group C was higher than those in group A and B (P<0.05). Meanwhile, compared with other groups, Group C had a longer pregnant period, lower neonatal death rate and less perinatal compilations (P<0.05). Conclusion Biological fibrin glue closure via the cervical intubation with the monitoring of amnioscopy is effective and easy to be manipulated, which can avoid the influence of water injection on the coagulation of biological fibrin glue. Therefore, it's worthy to be

  9. The analysis of premature rupture of membranes in late pregnancy cervical secretions cultivation and neonatal infections%妊娠晚期胎膜早破孕妇宫颈分泌物培养与新生儿感染分析

    Institute of Scientific and Technical Information of China (English)

    王金凤; 陈升平

    2016-01-01

    Objective To investigate the relationship between the cultivation of cervical secretion in the late pregnancy with premature rupture of membranes and neonatal infection. Method From January 2013 to December 2015, 1140 cases of gravida with premature rupture of membranes in our hospital were adopted in premature rupture of membranes group, and 1054 cases of pregnant women were adopted in control group. Observed and analyzed the cultivation of cervical secretions, premature delivery, puerperal infection, neonatal jaundice, neonatal infection, low birth weight infant and neonatal death. Result Cultivation of cervical secretion of 769 gravida showing a bacterial phenomenon in premature rupture of membranes group, 660 cases in control group, and the Candida albicans was the most common in the two groups. Distribution of Lactobacillus and Acinetobacter in premature rupture of membranes group (16.78%, 1.43%) were higher than control group (13.79%, 0.30%) (P < 0.05). The distribution of Escherichia coli in premature rupture of membranes group (35.92%) was significantly higher than control group (23.75%) (P < 0.05). The incidence rate of puerperal infection, neonatal jaundice, neonatal infection, low birth weight infant and neonatal death in premature rupture of membranes group were higher than control group (P<0.05). Conclusion Candidiasis is the most vaginal flora of late trimester of pregnancy gravida, the vaginal flora imbalance leads the increase of incidence rate of premature rupture of membranes, puerperal infection and neonatal infection.%目的探讨妊娠晚期胎膜早破孕妇宫颈分泌物培养情况与新生儿感染的关系。方法选取2013年1月至2015年12月就诊于本院的1140例妊娠晚期胎膜早破的孕妇纳入胎膜早破组,选取本院同期1054例妊娠晚期无胎膜早破的孕妇纳入对照组,观察并分析两组孕妇宫颈分泌物的培养情况、早产、产褥感染、新生儿黄疸、新生儿感染、低体重儿和

  10. Your Premature Baby

    Science.gov (United States)

    ... birth defects, premature birth and infant mortality. Solving premature birth Featured articles Accomplishments and lessons learned since ... Complications & Loss > Preterm labor & premature birth > Premature babies Premature babies E-mail to a friend Please fill ...

  11. Clinical analysis of 80 cases’s pregnancy outcomes with premature of rupture of membranes%80例未足月胎膜早破孕妇的妊娠结局分析

    Institute of Scientific and Technical Information of China (English)

    马丽

    2014-01-01

    目的:探讨未足月胎膜早破(PPROM)对妊娠结局的影响。方法:对80例孕28~36+6周PPROM孕产妇和新生儿的临床资料进行回顾性分析。结果:孕28~33+6周PPROM组新生儿呼吸窘迫、缺血缺氧性脑病和肺炎,新生儿死亡率均明显高于孕34~36+6周PPROM组,孕28~33+6周PPROM组潜伏期在48h以内的新生儿呼吸窘迫、缺血缺氧性脑病和肺炎,新生儿死亡率均高于潜伏期在48h以后者,差异有统计学意义(P<0.05)。孕34~36+6周PPROM组潜伏期在48h以内者的孕产妇与潜伏期在48h以后者相关并发症发生率差异无统计学意义,结论:对孕28~33+6周PPROM应采取促胎肺成熟,延长孕周,适时终止妊娠;而孕34~36+6周PPROM胎儿肺成熟者应尽快终止妊娠。%Objective: To discuss the effects of different gestationalweeks and latent period on pregnancy out-comes in preterm premature rupture of membrane (PPROM). Methods: The data of 80 PPROM between 28~36+6 weeks with preterm were retrospectively analyzed. Results: Transient respiratory distress, hypoxia ischemic en-cephalopathy ( HIE) and pneumonia,death of the newborn were higher in 28~33+6 weeks of PPROM than those in 34~36+6 weeks of PPROM. In 28~33+6 weeks of PPROM, transient respiratory distress, HIE , pneumonia and death of the newborn were higher in group of latent period within 48h. There was statistic difference ( P<0. 05). In 34~36+6 weeks of PPROM, there was no statistic difference of maternal neonatal complication incidences between the different latent period. Conclusion: The suitable measures to treat the patients with PPROM at 28~33+6 gestational weeks are promoting fetal lung maturation,extending the gestational week and term ination the pregnancy at the right time, while to the patients with PPROM at 34~36+6 gestational week with maturation of the fetal lung it should termi-natethe pregnancy as soon as possible.

  12. Effect of delivery time of primiparous women after term premature rupture of membrane on mothers and their neonates%初产妇足月胎膜早破后分娩时间对母儿的影响

    Institute of Scientific and Technical Information of China (English)

    毛敏泓; 陈晨

    2012-01-01

    Objective; To explore the effects of the interval time between premature rupture of membrane (PROM) and delivery and antibiotics on prognosis of neonates and their mothers. Methods: A total of 452 primiparous women with PROM were analyzed retrospectively , and then they were divided into group A, group B, group C, and group D according to the interval time; the cesarean section rates, the amounts of postpartum hemorrhage, the incidences of chorioamnionitis, and the incidences of fetal distress in the four groups were analyzed retrospectively. The patients who gave birth to their babies within 12 hours after PROM were divided into group one and group two, the patients in group one were treated with antibiotics to prevent infection, while the patients in group two were not treated with antibiotics. Results: The infection rates of mothers and their neonates in group A, group B, group C, and group D increased gradually, the incidences of fetal distress, the rates of cesarean section, and the incidences of chorioamnionitis increased gradually; there was no statistically significant difference in infection rate between group one and group two (P > 0. 05) . Conclusion: Delivery after PROM as early as possible can effectively reduce various complications, the patients expected to delivery within 12 hours after PROM dont need antibiotics to prevent infection.%目的:探讨胎膜早破~分娩的时间间隔以及抗生素对新生儿和母亲预后的影响.方法:对初产胎膜早破患者452例进行回顾性分析,按胎膜早破~临产时间间隔分为A、B、C、D组,统计并分析各组产妇剖宫产率、产后出血量、绒毛膜羊膜炎发生率、胎儿窘迫发生率.胎膜早破后在12 h内分娩者进一步分为甲乙两组,甲组应用抗生素预防感染,乙组不用抗生素.结果:A、B、C、D各组母婴感染率逐渐升高,胎儿窘迫、手术产率及胎盘胎膜发生重度羊膜炎逐渐增加;甲乙两亚组间感染率

  13. Preterm Premature Rupture of Membranes in Late Incomplete Pregnancy:Clinical Records of 208 Cases%妊娠晚期未足月胎膜早破208例临床分析

    Institute of Scientific and Technical Information of China (English)

    宋美兰; 贾艳艳

    2011-01-01

    目的 探讨妊娠晚期未足月胎膜早破患者的治疗及妊娠结局.方法 对2006年1月~2010年12月在河南省商丘市妇幼保健院住院分娩的208例妊娠晚期未足月胎膜早破患者的临床资料进行回顾性分析.结果 生殖道炎症和胎位异常是胎膜早破发生的主要诱因,但大部分患者原因不明;妊娠晚期未足月胎膜早破患者经保胎治疗75.48%(157/208)的患者于48 h后分娩,为应用糖皮质激素促胎肺成熟争取了时间;25.48%(53/208)的患者以剖宫产结束妊娠,主要手术指征为骨盆因素及胎儿窘迫,因未足月胎儿相对较小,大部分患者可阴道分娩;胎龄28~31周的早产儿因发育不成熟等因素死亡率较高.结论 妊娠晚期未足月胎膜早破的发生对孕产妇和围产儿的影响较大.胎膜早破与胎位异常、生殖道感染等关系密切,胎膜早破的分娩时机及分娩方式的选择原则上应根据胎儿所处危险的大小来决定,抗生素和糖皮质激素的应用可改善新生儿的结局.%Objective To study the treatment and the pregnancy outcome of patients with preterm premature rupture of membranes(PPROM)in late pregnancy. Methods The clinic data of 208 cases of PPROM in late pregnancy were retrospectively analyzed. Results The genital tract inflammation and abnormal fetal position were the major cause of PPROM, but most patients had unknown reasons. 75.48% of the third trimester patients with PPROM(157/208)gave birth after 48 h,and were given glucocorticoids treatment to promote fetal lung maturation, 25.48 % ( 53/208) patients received cesarean section for termination of pregnancy. Most patients were subjected to vaginal delivery. The fetuses with 28 to 31 weeks gestational age had a higher mortality. Conclusion PPROM in the late pregnancy has a great impact on pregnant women and infants. Fetal anomalies and reproductive tract infections are closely related to PPROM. The delivery timing and mode of delivery

  14. Relationship of UU, CT, GBS infection with premature rupture of amniotic infection syndrome merger%UU、CT、G BS 感染与胎膜早破合并羊膜腔感染综合征的关系研究

    Institute of Scientific and Technical Information of China (English)

    葛新苗

    2015-01-01

    Objective It is to investigate the relationship of UU, chlamydia (CT), B streptococcus (GBS) infection with premature rupture of amniotic infection syndrome merger ( IAIS) .Methods The UU, CT infection rate of 84 cases of pregnant women (32 cases of premature rupture of membranes;52 cases of alone combined amniotic infection) and 60 patients without tire premature rupture of membranes in pregnant women as a control group were detected with colloidal gold and GBS infection rate were detected with PCR.The UU, CT, GBS infection on maternal outcome of pregnancy were analyzed.Results The UU, CT, GBS infection positive rate of premature rupture of membranes group and merge amniotic groups were higher than control group (P<0.05),the UU, CT, GBS infection positive rate of combined amniotic infection were higher than premature rupture of membranes group (P<0.05).The merge simple amniotic infection cesarean section, postpartum hemorrhage, prolonged la-bor, puerperal infection rate of membranes group and merge amniotic groups were higher than control group (P<0.05).The merge simple amniotic infection cesarean section, postpartum hemorrhage, prolonged labor, puerperal infection rate of mem-branes group and merge amniotic groups were higher than control group (P<0.05).The premature rupture , fetal distress, perinatal death rate, meconium, neonatal asphyxia, neonatal pneumonia, premature children, intrauterine stunting, cord en-tanglement, premature rupture of membranes group perinatal infection were higher than alone combined amniotic infection group( P<0.05) .Conclusion UU, CT, GBS infection may be risk factors for the occurrence of IAIS, UU, CT, GBS infec-tion may increase the incidence of maternal adverse pregnancy outcomes, should lead to clinical attention.%目的:探讨解脲支原体(UU)、衣原体(CT)、B族链球菌(GBS)感染与胎膜早破合并羊膜腔感染综合征( IAIS)的关系。方法选择单纯胎膜早破孕妇32例作为单纯胎膜

  15. Sexuality in pregnancy and premature labour.

    Science.gov (United States)

    Georgakopoulos, P A; Dodos, D; Mechleris, D

    1984-09-01

    The relation of sexual behaviour during pregnancy to the initiation of labour was investigated in 358 patients of whom 58 were delivered after premature labour and 300 were delivered spontaneously at term. In all patients the mean weekly coital frequency and the frequency of orgasm were investigated by means of a retrospective questionnaire. There was no significant difference in coital or orgasmic frequency between the women who had a premature labour and those who had a spontaneous delivery at term. This was also true when those having premature labour were divided into those starting labour with ruptured membranes and those starting with contractions.

  16. Osteopenia - premature infants

    Science.gov (United States)

    Neonatal rickets; Brittle bones - premature infants; Weak bones - premature infants; Osteopenia of prematurity ... the baby. This helps the baby grow. A premature infant may not receive the proper amount of ...

  17. Premature delivery

    Directory of Open Access Journals (Sweden)

    Bernardita Donoso Bernales

    2012-09-01

    Full Text Available Preterm delivery is the single most important cause of perinatal morbidity and mortality. In Chile, preterm births have increased in the past decade, although neonatal morbidity and mortality attributable to it shows a downward trend, thanks to improvements in neonatal care of premature babies, rather than the success of obstetric preventive and therapeutic strategies. This article describes clinical entities, disease processes and conditions that constitute predisposing factors of preterm birth, as well as an outline for the prevention and clinical management of women at risk of preterm birth.

  18. Ruptura prematura das membranas amnióticas no pré-termo: fatores associados à displasia broncopulmonar Preterm premature rupture of the fetal membranes: factors associated with bronchopulmonary dysplasia

    Directory of Open Access Journals (Sweden)

    Danieli Dias Gonçalves

    2010-10-01

    Full Text Available OBJETIVO: identificar os fatores obstétricos e neonatais associados ao desfecho de displasia broncopulmonar em pacientes com amniorrexe prematura no pré-termo. MÉTODOS: foram analisados 213 prontuários do Instituto Fernandes Figueira, entre 1998 e 2002, cujas pacientes evoluíram com quadro de amniorrexe prematura 10 dias (OR: 54,00 [11,55-278,25] p=0,000; idade gestacional 10 dias (p=0,001 e "uso de surfactante" (p=0,040 permaneceram independentemente associadas ao desfecho. CONCLUSÕES: observou-se que os fatores associados à displasia broncopulmonar são de natureza neonatal, sendo que a ventilação mecânica duradoura e o uso de surfactante neonatal influenciaram no desenvolvimento dessa doença.PURPOSE: to analyze obstetric and neonatal factors associated with bronchopulmonary dysplasia outcome in patients with preterm premature amniorrhexis. METHODS: we analyzed 213 medical records of patients of Fernandes Figueira Institute who suffered premature amniorrhexis (10 days (p=0.001 and "use of a surfactant" (p=0.040 remained independently associated with bronchopulmonary dysplasia. CONCLUSIONS: the factors associated with bronchopulmonary dysplasia are related to neonatal features, asprolonged mechanical ventilation and the use of a surfactant influencethe development of thedisease.

  19. Infection and prematurity and the role of preventive strategies.

    Science.gov (United States)

    Romero, Roberto; Espinoza, Jimmy; Chaiworapongsa, Tinnakorn; Kalache, Karim

    2002-08-01

    This article reviews the role of infection in spontaneous premature parturition, the pathways of ascending intrauterine infection, microbiology, and the frequency of intra-amniotic infection in obstetrical complications leading to premature delivery. The evidence that infection is causally linked to premature birth is critically examined, as is the relationship between urogenital tract infection/colonization with microorganisms and the risk of preterm birth. The effect of antibiotic administration in perinatal outcome in patients with preterm labor and intact membranes, preterm premature rupture of membranes, asymptomatic bacteriuria, Group B streptococcus and genital mycoplasmas of the lower genital tract, and bacterial vaginosis are critically examined.

  20. Intrauterine infection and prematurity.

    Science.gov (United States)

    Gonçalves, Luís F; Chaiworapongsa, Tinnakorn; Romero, Roberto

    2002-01-01

    Intrauterine infection is a major cause of premature labor with and without intact membranes. Intrauterine infection is present in approximately 25% of all preterm births and the earlier the gestational age at delivery, the higher the frequency of intra-amniotic infection. Microorganisms may also gain access to the fetus before delivery. A fetal inflammatory response syndrome elicited in response to microbial products is associated with the impending onset of preterm labor and also with multi-systemic organ involvement in the human fetus and a higher rate of perinatal morbidity. The most common microorganisms involved in intrauterine infections are Ureaplasma urealyticum, Fusobacterium species and Mycoplasma hominis. The role of Chlamydia trachomatis and viruses in preterm labor remain to be determined. Use of molecular microbiology techniques to diagnose intrauterine infection may uncover the role of fastidious microorganisms that have not yet been discovered. Antibiotic administration to patients with asymptomatic bacteriuria is associated with a significant reduction in the rate of preterm birth. However, such benefit has not been demonstrated for patients with bacterial vaginosis, or women who carry Streptococcus agalactia, Ureaplasma urealyticum or Trichomonas vaginalis. Antibiotic administration to patients with preterm premature rupture of membranes is associated with prolongation of pregnancy and a reduction in the rate of clinical chorioamnionitis and neonatal sepsis. The benefit has not been demonstrated in patients with preterm labor and intact membranes. Major efforts are required to determine why some women develop an ascending intrauterine infection and others do not and also what interventions may reduce the deleterious effect of systemic fetal inflammation. Copyright 2002 Wiley-Liss, Inc.

  1. Premature Ventricular Contractions (PVCs)

    Science.gov (United States)

    Diseases and Conditions Premature ventricular contractions (PVCs) By Mayo Clinic Staff Premature ventricular contractions (PVCs) are extra, abnormal heartbeats that begin in one of your heart's two ...

  2. Premature ejaculation

    Directory of Open Access Journals (Sweden)

    Chris G McMahon

    2007-01-01

    Full Text Available Premature ejaculation (PE is a common male sexual disorder. Recent normative data suggests that men with an intravaginal ejaculatory latency time (IELT of less than 1 minute have "definite" PE, while men with IELTs between 1 and 1.5 minutes have "probable" PE. Although there is insufficient empirical evidence to identify the etiology of PE, there is limited correlational evidence to suggest that men with PE have high levels of sexual anxiety and inherited altered sensitivity of central 5-HT (5-hydroxytryptamine, serotonin receptors. Pharmacological modulation of the ejaculatory threshold using off-label daily or on-demand selective serotonin re-uptake inhibitors is well tolerated and offers patients a high likelihood of achieving improved ejaculatory control within a few days of initiating treatment, consequential improvements in sexual desire and other sexual domains. Investigational drugs such as the ejaculo-selective serotonin transport inhibitor, dapoxetine represent a major development in sexual medicine. These drugs offer patients the convenience of on-demand dosing, significant improvements in IELT, ejaculatory control and sexual satisfaction with minimal adverse effects.

  3. Premature ejaculation.

    Science.gov (United States)

    McMahon, Chris G

    2007-04-01

    Premature ejaculation (PE) is a common male sexual disorder. Recent normative data suggests that men with an intravaginal ejaculatory latency time (IELT) of less than 1 minute have "definite" PE, while men with IELTs between 1 and 1.5 minutes have "probable" PE. Although there is insufficient empirical evidence to identify the etiology of PE, there is limited correlational evidence to suggest that men with PE have high levels of sexual anxiety and inherited altered sensitivity of central 5-HT (5-hydroxytryptamine, serotonin) receptors. Pharmacological modulation of the ejaculatory threshold using off-label daily or on-demand selective serotonin re-uptake inhibitors is well tolerated and offers patients a high likelihood of achieving improved ejaculatory control within a few days of initiating treatment, consequential improvements in sexual desire and other sexual domains. Investigational drugs such as the ejaculo-selective serotonin transport inhibitor, dapoxetine represent a major development in sexual medicine. These drugs offer patients the convenience of on-demand dosing, significant improvements in IELT, ejaculatory control and sexual satisfaction with minimal adverse effects.

  4. 初产妇足月胎膜早破406例分娩方式及新生儿结局的分析%Analysis of delivery way and neonatal outcome of 406 cases of primipara term premature rupture of membranes

    Institute of Scientific and Technical Information of China (English)

    费翠芹; 范桂金

    2014-01-01

    目的:探讨初产妇足月胎膜早破的分娩时机、方式对母婴结局的影响及其合理的处理措施。方法:2012年1月-2013年12月收治足月胎膜早破初产妇406例,分为12 h内临产、24 h内临产和24 h后引产组,进行初产妇分娩方式、产妇及新生儿并发症统计学比较。结果:与12 h内临产组相比,24 h内临产组自然分娩率下降,难产及剖宫产率升高但无统计学意义,其胎儿宫内窘迫、新生儿窒息及产后出血亦无统计学意义(P>0.05);而引产组自然分娩率明显下降,难产及剖宫产率明显升高,差异有统计学意义,其胎儿宫内窘迫、新生儿窒息与临产组比较有统计学意义(P<0.05),但产后出血无统计学意义(P>0.05)。结论:24 h后行引产的足月胎膜早破初产妇剖宫产率明显增加,且可增加围生儿并发症。%Objective:To explore the influence of delivery time and way of primipara term premature rupture of membranes on maternal and child outcome and reasonable treatment measures.Methods:406 primiparas with term premature rupture of membranes were selected from January 2012 to December 2013.They were divided into labor within 12 hours group,labor within 24 hours group and labor induction after 24 hours group.The primipara delivery way,the complications of maternal and neonatal were statistical compared.Results:Compared with labor within 12 hours group,the natural delivery rate of labor induction after 24 hours group was reduced;the dystocia and cesarean section rate were increased,but there were no statistical significance;the fetal distress,neonatal asphyxia and postpartum hemorrhage had no statistical significance(P>0.05).The natural delivery rate of induced labor group was reduced;the dystocia and cesarean section rate were increased;there were statistical significance;the fetal distress and neonatal asphyxia had statistical significance compared with labor group(P0.05).Conclusion

  5. Correlação entre a idade materna, paridade, gemelaridade, síndrome hipertensiva e ruptura prematura de membranas e a indicação de parto cesáreo The influence of maternal age, parity, twin pregnancy, hypertensive syndrome and premature rupture of membranes on the indication for cesarean section

    Directory of Open Access Journals (Sweden)

    Simone Angélica Leite de Carvalho Silva Cabral

    2003-12-01

    Full Text Available OBJETIVO: verificar a contribuição da idade materna, paridade, gemelaridade, síndrome hipertensiva, ruptura prematura das membranas como fator de risco para cesárea. MÉTODOS: após aprovação do Comitê de Ética em Pesquisa da Maternidade Professor Monteiro de Morais, situada em Recife-PE, realizou-se estudo de caso-controle com 3919 gestantes, sem antecedente de duas ou mais cesáreas, que deram à luz concepto vivo, com idade gestacional igual ou superior a 28 semanas, peso mínimo de 1.000 g, em apresentação cefálica, no período de 1 de setembro de 1999 a 31 de agosto de 2000. No grupo caso foram incluídas mulheres submetidas a operação cesariana e no grupo controle, a parto vaginal. Com os dados constantes dos prontuários neonatais e obstétricos, realizou-se análise multivariada por regressão logística, buscando a equação matemática que relacione a probabilidade de ocorrência de cesárea decorrente de mais de uma variável independente atuando como fator de risco, utilizando odds ratio e intervalo de confiança de 95% (IC 95%, consideradas as variáveis: idade materna, paridade, gemelaridade, síndrome hipertensiva e ruptura prematura das membranas. RESULTADOS: as chances de cesárea foram aumentadas em 8,3 vezes (OR = 8,3; IC 95%: 3,7-19,1 na gemelaridade, 3,4 na síndrome hipertensiva (OR = 3,4; IC 95%: 2,9-4,0, 1,9 na primiparidade (OR = 1,9; IC 95% : 1,8-2,0, 1,5 na idade superior a 34 anos (OR = 1,5; IC 95%: 1,2-1,8 e 1,2 na presença de ruptura prematura das membranas (OR = 1,2; IC 95%: 1,0-1,4. CONCLUSÕES: ruptura prematura das membranas, idade superior a 34 anos, primiparidade, síndrome hipertensiva e gemelaridade constituíram fatores de risco para cesárea.PURPOSE: to verify the contribution of maternal age, parity, twin pregnancy, hypertensive syndrome, and premature rupture of membranes as risk factors for cesarean section. METHODS: after approval by the Ethics in Research Committee of the "Maternidade

  6. Uso de misoprostol retal para indução do parto em gestantes com amniorrexe prematura: ensaio clínico fase II Use of rectal misoprostol for induction of labor in patients with premature rupture of membranes: a phase II clinical trial

    Directory of Open Access Journals (Sweden)

    Francisco Carlos Nogueira Arcanjo

    2003-08-01

    Full Text Available OBJETIVO: avaliar se o misoprostol por via retal constitui método efetivo para indução do parto em gestantes com amniorrexe prematura a termo. MÉTODOS: realizou-se estudo piloto, incluindo 32 gestantes com amniorrexe prematura entre 36 e 41 semanas, feto vivo e único, em apresentação cefálica, escore de Bishop 18 horas receberam antibiótico (penicilina cristalina para profilaxia de infecção estreptocócica. Analisaram-se desfechos diversos como intervalo entre indução e início do trabalho de parto, entre indução e parto, incidência de taquissistolia, tipo de parto, incidência de corioamnionite e resultados neonatais. A análise estatística foi realizada no programa de domínio público Epi-Info 2002, calculando-se médias com os respectivos desvios-padrão, além de distribuições de freqüência. Realizou-se análise de sobrevivência para determinação do percentual de partos em função do tempo transcorrido (em horas desde a administração do primeiro comprimido. RESULTADOS: os intervalos (média ± desvio padrão entre indução e início das contrações e entre indução e parto foram de, respectivamente, 299,8±199,9 e 681±340,5 minutos. Observou-se freqüência de 9,4% de taquissistolia. Cerca de 72% das pacientes evoluíram para parto vaginal. Diagnosticou-se corioamnionite em 12,5% dos casos. As medianas dos escores de Apgar foram de 8 e 9 no primeiro e quinto minuto, respectivamente. Não houve nenhum caso de Apgar PURPOSE: to investigate whether rectally administered misoprostol is an effective method for induction of labor in patients with premature ruptured membranes at term. METHODS: a pilot trial was conducted, enrolling 32 women with alive, singleton, cephalic fetus and ruptured membranes between 36 and 41 weeks of pregnancy, with Bishop score 18 h received antibiotics (crystalline penicillin for prophylaxis of streptococcal infeccion. Outcomes included time from induction to labor and induction to

  7. Retinopathy of Prematurity (ROP)

    Science.gov (United States)

    ... of Prematurity (ROP) Facts About Retinopathy of Prematurity (ROP) This information was developed by the National Eye ... blind from ROP. Are there different stages of ROP? Yes. ROP is classified in five stages, ranging ...

  8. Pharmacotherapy for premature ejaculation

    NARCIS (Netherlands)

    Waldinger, Marcel D

    PURPOSE OF REVIEW: As there are various drugs and different treatment strategies to delay ejaculation, a review of the current drug treatments for premature ejaculation is relevant for daily clinical practice. RECENT FINDINGS: There are four premature ejaculation subtypes: lifelong premature

  9. Pharmacotherapy for premature ejaculation

    NARCIS (Netherlands)

    Waldinger, Marcel D

    2014-01-01

    PURPOSE OF REVIEW: As there are various drugs and different treatment strategies to delay ejaculation, a review of the current drug treatments for premature ejaculation is relevant for daily clinical practice. RECENT FINDINGS: There are four premature ejaculation subtypes: lifelong premature ejacula

  10. Adherence to good practices in membrane premature rupture. Perinatology Service. University Hospital “Dr. Gustavo Aldereguía Lima”, Cienfuegos city. From January to December 2002. Adherencia a buenas prácticas en rotura prematura de membranas. Servicio Perinatología. Hospital "Dr. Gustavo Aldereguia Lima". Cienfuegos. Enero- diciembre 2002.

    Directory of Open Access Journals (Sweden)

    Yosleidy Capote Fragoso

    2004-12-01

    Full Text Available Fundament:Nursing good practice demands standardizationof care,in such a way that they guide and unite the different ways of performance. Objetive: to determine the adherence of the care plan to the guide of good nursing practice in the premature rupture of the membranes and the level of the staff for the level of preparation for its performance in the Service of Perinatology. Methods: Descriptive, correlational and prospective study applied to 622 pregnant women admitted at the Perinatology Service of ¨Dr. Gustavo Aldereguía Lima¨ Hospital from Cienfuegos province who had a rupture of the membrane. 311 patients (50% of the universe, selected with probabilistic simple randomized way, without exclusive criteria were studied. Adherence was measured by using evaluation means. Results:43 % of the assessed clinical records, received between 95 and 100 points . Among the 16 nurses evaluated , 43,7 % had difficulties, being 25 % technicians.

    Fundamento:Las buenas prácticas de enfermería exigen la estandarización de los cuidados, de modo que guíe y unifique los diferentes modos de actuación. Objetivo: Determinar la adherencia del plan de cuidado a la guía de la buena práctica de enfermería en la rotura prematura de membranas y el grado de preparación del personal para su realización en el Servicio de Perinatología.Métodos: Estudio descriptivo, correlacionar y retrospectivo realizado en un universo de 622 gestantes ingresadas en el Servicio de Perinatología del Hospital ¨Gustavo Aldereguía Lima¨ de Cienfuegos con rotura prematura de membranas, del que se tomó una muestra de 311 pacientes, el 50 % del universo, escogidas por el método probabilistico al azar simple por sorteo, sin criterios de exclusión. La adherencia fue medida a través de instrumentos de

  11. Health Issues of Premature Babies

    Science.gov (United States)

    ... Text Size Email Print Share Health Issues of Premature Babies Page Content Because premature babies are born before they are physically ready ... associated with prematurity. Because of these health concerns, premature babies are given extra medical attention and assistance ...

  12. The Relationship Between Pregnancy Outcomes and the Residue Amniotic Fluid Volume After Premature Rupture of Membranes in the Normal Period of Gestation%足月胎膜早破孕妇剩余羊水量与妊娠结局

    Institute of Scientific and Technical Information of China (English)

    余立波

    2014-01-01

    目的:探讨足月胎膜早破孕妇剩余羊水量对妊娠结局的影响。方法孕足月胎膜早破孕妇分为羊水量正常组、羊水量偏少组、羊水量过少组。统计分析三组宫内感染、剖宫产率、胎儿宫内窘迫及新生儿窒息的差别。结果羊水量过少组剖宫产率、胎儿宫内窘迫发生率、新生儿窒息的发生率高于另外两组(P<0.05);三组间羊膜腔感染率差异无统计学意义(P>0.05)。结论胎膜早破的剩余羊水量过少可导致剖宫产率、胎儿宫内窘迫及新生儿窒息发生率升高。%Objective: To determine the relationship between the residue amniotic fluid volume after premature rupture of membranes (PROM) in the normal period of gestation. Methods:According to amniotic fluid index (AFI) by ultrasound, pregnant women were divided intogroup of normal amniotic fluid, group of borderline oligohydramnios, and group of oligohydramnios. Analyzed and compared the rate of intrauterine infection, cesarean section, fetal distress and neonatal asphyxia. Result: Group of oligohydramnios had a high rates of cesarean section, fetal distress and neonatal asphyxia compared with other two groups (P0.05). Conclusion:Oligohydramnios after PROM is associated with the increasing risks of cesarean section, fetal distress and neonatal asphyxia.

  13. Achilles Tendon Rupture

    Science.gov (United States)

    Achilles tendon rupture Overview By Mayo Clinic Staff Achilles (uh-KILL-eez) tendon rupture is an injury that affects the back ... but it can happen to anyone. The Achilles tendon is a strong fibrous cord that connects the ...

  14. Correlation analysis of outcome of pregnancy according to the residual amount of amniot-ic fluid after full-term premature rupture of fetal membranes%足月胎膜早破残余羊水量对妊娠结局的影响

    Institute of Scientific and Technical Information of China (English)

    石海霞; 杭木兰

    2015-01-01

    目的:回顾性分析足月胎膜早破后残余羊水量对妊娠结局的影响。方法收集143例足月胎膜早破孕产妇临床资料,根据产前B超检测的残余羊水指数(AFI)分为三组:A组(8 cm≤AFI<25 cm)75例,B组(5 cm≤AFI<8 cm)38例,C组( AFI<5 cm )30例,比较三组孕妇在分娩方式、宫内感染率、胎儿窘迫率、新生儿发病率和羊水粪染率等方面的差异。结果 C组剖宫产率高于A组(70.00%vs 37.30%,P<0.05);A组自然分娩率高于B组和C组,差异均有统计学意义( P<0.05)。 C组宫内感染发生率、新生儿疾病发生率、羊水粪染率、胎儿窘迫发生率均高于A组,差异有统计学意义(P<0.05),其他组间比较均无统计学差异。 Logistic回归分析表明,残余羊水量(OR=2.912)、破膜至分娩时间(OR=2.356)与羊水粪染( OR=1.833)是产妇宫内感染率、新生儿疾病发病率的影响因素。结论足月胎膜早破后残余羊水量的多少与妊娠结局密切相关,羊水残余量越少对母婴的威胁越大。%Objective To analyze and discuss the impacts of the outcome of pregnancy according to the residual amount of am-niotic fluid after full-term premature rupture of fetalmembranes.Methods 143 puerperas were divided into three groups according to their prenatal B ultrasound detection of residual amniotic fluid index(AFI) results, including Group A (8 cm≤AFI<25 cm) 75 ca-ses,Group B(5 cm≤AFI<8 cm) 38 cases and Group C(AFI <5 cm) 30 cases.Thedifferenceswere comparedbetween the three groups of pregnant women in mode of delivery, intrauterine infection, fetal distress, neonatal morbidity and meconium stained amniotic fluid rate.Results The cesarean section rate in Group C was significantly higher than in Group A (70.00%vs 37.30%,P<0.05). The spontaneous vaginal delivery rates in Group C and Group B were lower than in Group A, with a significant

  15. the use of dexamethasone in women with preterm premature rupture ...

    African Journals Online (AJOL)

    C Stewart, D Woods, G Moller, E Coetzee, P Smith,. JAnthony; University of the ... advocate their [antenatal corticosteroids] routine use in this ... first 3 days after birth. These tests ..... preterm labour or elective preterm delivery', and that this is.

  16. 未足月胎膜早破残余羊水量与妊娠结局的相关性研究%Study on the Correlation between Residual Amniotic Fluid Volume of Preterm Premature Rupture of Membranes and Pregnancy Outcome

    Institute of Scientific and Technical Information of China (English)

    陶冬梅

    2013-01-01

      目的:探讨未足月胎膜早破残余羊水量与妊娠结局的相关性。方法:选择2005年1月-2011年12月于笔者所在医院住院分娩的105例未足月胎膜早破孕妇,根据胎膜破裂后羊水指数(AFI)的测定结果将孕妇分为羊水量正常组、羊水量偏少组、羊水量过少组,三组均予抗生素预防感染、糖皮质激素促胎肺成熟、宫缩抑制剂抑制宫缩等治疗,观察比较分析三组相关指标。结果:羊水量过少组孕妇破膜后的潜伏时间、羊膜腔感染、新生儿早期败血症、产后子宫内膜炎、胎儿窘迫、新生儿窒息、缺氧缺血心肌损害、围生儿死亡情况等方面比较差异均有统计学意义(均P0.05),高于羊水量正常组(P0.05),higher than the amount of normal group (P<0.05).Conclusion:In pregnant women without premature rupture of membranes at term,looking for water treatment process to close monitoring of the sheep,monitoring for symptoms such as infection,fetal distress,assess mother son,relax appropriately cesarean section indications,its emergency cesarean delivery end of pregnancy,postpartum and strengthening resistance to infection,prevention and treatment of diseases such as neonatal asphyxia,maternal infection,perinatal morbidity and mortality.

  17. Ruptured abdominal aortic aneurysm.

    Science.gov (United States)

    Sachs, T; Schermerhorn, M

    2010-06-01

    Ruptured abdominal aortic aneurysm (AAA) continues to be one of the most lethal vascular pathologies we encounter. Its management demands prompt and efficient evaluation and repair. Open repair has traditionally been the mainstay of treatment. However, the introduction of endovascular techniques has altered the treatment algorithm for ruptured AAA in most major medical centers. We present recent literature and techniques for ruptured AAA and its surgical management.

  18. Resolution of alliance ruptures: The special case of animal-assisted psychotherapy.

    Science.gov (United States)

    Zilcha-Mano, Sigal

    2017-01-01

    Many therapists regard alliance ruptures as one of the greatest challenges therapists face in the therapy room. Alliance ruptures has been previously defined as breakdowns in the process of negotiation of treatment tasks and goals and a deterioration in the affective bond between patient and therapist. Alliance ruptures have been found to predict premature termination of treatment and poor treatment outcomes. But ruptures can also present important opportunities for gaining insight and awareness and for facilitating therapeutic change. A process of rupture resolution may lead to beneficial outcomes and serve as a corrective emotional experience. The article describes unique processes of alliance rupture resolution inherent in animal-assisted psychotherapy (AAP). Building on Safran and Muran's model and on clinical examples, the article describes strategies for identifying ruptures in AAP and techniques for repairing them to facilitate a corrective experience in treatment. Implications for clinical practice and future research are discussed.

  19. The relationship of the subtypes of preterm birth with retinopathy of prematurity.

    Science.gov (United States)

    Lynch, Anne M; Wagner, Brandie D; Hodges, Jennifer K; Thevarajah, Tamara S; McCourt, Emily A; Cerda, Ashlee M; Mandava, Naresh; Gibbs, Ronald S; Palestine, Alan G

    2017-09-01

    Retinopathy of prematurity is an adverse outcome of preterm birth and is a leading cause of childhood blindness. The relationship between the subtypes of preterm birth with retinopathy of prematurity is understudied. To investigate whether there is a difference in the incidence of type 1 or type 2 retinopathy of prematurity in infants with preterm birth resulting from spontaneous preterm labor, a medical indication of preterm birth, or preterm premature rupture of the membranes. A retrospective cohort study was conducted of 827 infants screened for retinopathy of prematurity who were delivered at a single tertiary care center in Colorado. All infants fulfilled the American Academy of Pediatrics 2013 screening criteria for retinopathy of prematurity defined as "infants with a birth weight of ≤1500 g or gestational age of 30 weeks or less (as defined by the attending neonatologist) and selected infants with a birth weight between 1500 and 2000 g or gestational age of >30 weeks with an unstable clinical course, including those requiring cardiorespiratory support and who are believed by their attending pediatrician or neonatologist to be at high risk for retinopathy of prematurity." Two independent reviewers masked to retinopathy of prematurity outcomes determined whether preterm birth resulted from spontaneous preterm labor, medical indication of preterm birth, or preterm premature rupture of the membranes. Discrepancies were resolved by a third reviewer. Data were analyzed with univariate and multivariable logistic regression. In our cohort, the frequency of preterm birth resulting from spontaneous preterm labor, medical indication of preterm birth, or preterm premature rupture of the membranes was 34%, 40%, and 26%, respectively. The mean gestational age (weeks, days) ± SD (range) in the cohort and across the preterm birth subtypes was as follows: entire cohort, 28 weeks, 6 days ± 2 weeks, 3 days (23 weeks, 3 days - 36 weeks, 4 days); spontaneous preterm labor

  20. Infectious characteristic analysis and drug-resistance of pathogens among vagina infection pregnancy with premature rup-ture of membranes%阴道病原菌感染与胎膜早破的关系及其耐药性分析

    Institute of Scientific and Technical Information of China (English)

    楚丽娟; 罗婷婷; 杨桂林; 李秋红

    2014-01-01

    Objective The distribution characteristics and antibiotic resistance of specific pathogens among va-gina infection pregnancy with premature rupture of membranes (prom) ,in order to guide rational antibacterial thera-py .Methods During the periods of Jan ,2010 to Jul ,2012 ,pathogens from vagina with infectious pregnancy were gathered ,two groups-prom group and normal control were divided .The drug sensitivity of isolated strains were deter-mined by the broth dilution method .Results Only Streptococcus agalactiae (b group) and Staphylococcus aureus were found statistical significance between the two groups ,presenting higher detection in prom group(P<0 .05) .The resistant rates of Staphylococcus aureus to penicillin and ampicillin were 100% ,the sensitivity rates to erythrocin and azithromycin were 33 .3% and 50% ,respectively ,to tetracycline were 66 .7% ,others were all above of 83 .3% .The sensitivity rates of Streptococcus agalactiae (b group) to levofloxacin ,azithromycin ,erythrocin ,and ofloxacin were 30% ~40% ,yet above 80% of sensitivity to penicillin and cephems .Conclusion Streptococcus agalactiae (b group) and Staphylococcus aureus have an effect on prom .The drug sensitivity to the two bacteria are effected .Rational use of antibiotics and surveillance should be taken into account ,to avoid the development of drug-resistance strains .%目的:探讨影响孕妇胎膜早破的具体病原菌及其耐药情况,以合理地指导临床用药。方法随机选取2010年1月至2012年7月该院就诊的感染性胎膜早破的妊娠晚期女性为研究对象(患者组),未发生胎膜早破的孕妇作为对照(健康对照组),收集阴道分泌物病原菌,采用肉汤法进行药敏试验。结果患者组病原菌表现为无乳链球菌(b群)和金黄色葡萄球菌检出率高于健康对照组,差异有统计学意义( P<0.05)。金黄色葡萄球菌对氨苄西林和青霉素完全耐药,对红霉素和克

  1. Comparação entre conduta ativa com ocitocina e conduta expectante na rotura prematura de membranas em gestações a termo Comparison between active management with oxytocin and expectant management for premature rupture of membranes at term

    Directory of Open Access Journals (Sweden)

    Ricardo Porto Tedesco

    1998-10-01

    Full Text Available Objetivos: comparar, em uma população de gestantes brasileiras com rotura prematura de membranas a termo (RPM-T, as condutas expectante ou ativa com ocitocina. Métodos: ensaio clínico prospectivo, randomizado e multicêntrico, avaliando as variáveis relativas ao tempo para o início do trabalho de parto e parto e tempo de internação hospitalar materna e neonatal. Foram selecionadas 200 gestantes com RPM-T, atendidas em quatro instituições públicas do estado de São Paulo de novembro de 1995 a fevereiro de 1997. As pacientes foram divididas aleatoriamente em dois grupos de conduta: ativa, com indução do trabalho de parto com ocitocina iniciando até 6 h de RPM, e expectante, aguardando-se o início espontâneo do trabalho de parto por um período máximo de 24 h. Os dados foram analisados com o auxílio dos programas Epi-Info e SPSS-PC+, utilizando-se os testes estatísticos do chi², t de Student e Log-rank. Resultados: indicam que as diferenças entre a utilização da conduta ativa com ocitocina e a conduta expectante dizem respeito ao maior tempo necessário no grupo de conduta expectante para o início do trabalho de parto e parto, além da maior proporção de mulheres e recém-nascidos com internação superior a três dias. Conclusões: o tempo entre a admissão e o parto, o período de latência e o tempo entre a rotura das membranas e o parto foram maiores quando se adotou conduta expectante.Objective: to compare the expectant versus active management with oxytocin in a Brazilian population of pregnant women with premature rupture of membranes (PROM at term. Methods: a prospective, randomized and multicenter clinical trial was performed, evaluating variables concerning the time from PROM until the onset of labor and delivery, and maternal and neonatal hospitalization periods. Two hundred pregnant women with PROM at term were selected from four public hospitals in São Paulo state, from November 1995 to February 1997. They

  2. Comprimento cervical como preditor do período de latência e de infecção na rotura prematura pré-termo de membranas Cervical length as a predictor of the latent period and infection in preterm premature membranes rupture

    Directory of Open Access Journals (Sweden)

    Carla Roberta Macedo de Sousa

    2012-04-01

    Full Text Available OBJETIVO: Avaliar o comprimento cervical, por ultrassonografia transvaginal, em pacientes entre 28 e 34 semanas de idade gestacional, correlacionando com o período de latência e o risco de infecção materna e neonatal. MÉTODOS: Foram avaliadas 39 pacientes divididas em relação ao comprimento cervical nos pontos de corte de 15, 20 e 25 mm. Em relação ao período de latência, foram avaliados os parâmetros de 72 horas. Foram incluídas gestantes com feto vivo e idade gestacional entre 28 e 34 semanas, com diagnóstico confirmado na admissão de rotura prematura de membranas. Pacientes com corioamnionite, gestação múltipla, malformações fetais, malformações uterinas (útero bicorno, septado e didelfo, antecedentes de cirurgia prévia no colo uterino (conização e cerclagem e dilatação do colo maior de 2 cm nas nulíparas e 3 cm nas multíparas foram excluídas no estudo. RESULTADOS: O comprimento do colo PURPOSE: To verify cervical length using transvaginal ultrasonography in pregnant women between 28 and 34 weeks of gestation, correlating it with the latent period and the risk of maternal and neonatal infections. METHODS: 39 pregnant women were evaluated and divided into groups based on their cervical length, using 15, 20 and 25 mm as cut-off points. The latency periods evaluated were three and seven days. Included were pregnant women with live fetuses and gestational age between 28 and 34 weeks, with a confirmed diagnosis on admission of premature rupture of membranes. Patients with chorioamnionitis, multiple gestation, fetal abnormalities, uterine malformations (bicornus septate and didelphic uterus, history of previous surgery on the cervix (conization and cerclage and cervical dilation greater than 2 cm in nulliparous women and 3 cm in multiparae were excluded from the study. RESULTS: A <15 mm cervical length was found to be highly related to a latency period of up to 72 hours (p=0.008. A <20 mm cervical length was also

  3. Micafungin in Premature and Non-premature Infants

    Science.gov (United States)

    Wu, Chunzhang; Tweddle, Lorraine; Roilides, Emmanuel

    2014-01-01

    Background: Invasive fungal infections cause excessive morbidity and mortality in premature neonates and severely ill infants. Methods: Safety and efficacy outcomes of micafungin were compared between prematurely and non-prematurely born infants premature [birth weight (BW) premature, received ≥1 dose of micafungin. Among premature patients, 14.5% were low BW (1500–2499 g), 36.4% very low BW (1000–1499 g) and 49.1% extremely low BW (premature)] died. Significantly more non-premature than premature patients discontinued treatment (P = 0.003). Treatment-related adverse events were recorded in 23% of patients with no difference between groups. More extremely low BW (n = 4, 15%) and very low BW (n = 8, 40%) infants experienced treatment-related adverse events than low BW (n = 0) and there was no relation to micafungin dose or duration. For a subgroup of 30 patients with invasive candidiasis, treatment success was achieved in 73% in both premature and non-premature groups. Prophylaxis was successful in 4/5 non-premature hematopoietic stem cell transplant patients. Conclusion: Micafungin has a safe profile in premature and non-premature infants with substantial efficacy. PMID:24892849

  4. 胰岛素样生长因子结合蛋白-1诊断胎膜早破的临床价值%Clinical Value of Insulin-Like Growth Factor Binding Protein-1 in Diagnosis of Premature Rupture of Membranes

    Institute of Scientific and Technical Information of China (English)

    孙素梅; 李守忠

    2016-01-01

    Objective To evaluate the clinical value of insulin-like growth factor binding pro-tein-1(IGFBP-1)in the diagnosis of premature rupture of membranes(PROM).Methods The vaginal secretion smear microscopy,pH test paper method and IGFBP-1 detection were performed in 276 PROM patients(PROM group)and 284 pregnant women without PROM(control group). Results were analyzed statistically.Results The positive rates achieved by IGFBP-1 detection, pH test paper method and vaginal secretion smear microscopy in PROM group were significantly higher than those in control group(all P < 0.01).The IGFBP-1 detection had a sensitivity of 97.1%(268/276),a specificity of 98.2%(279/284)and an accuracy of 95.3%,with a false posi-tive rate of 1.8%(5/284)and a false negative rate of 2.9%(8/276);The pH test paper method had a sensitivity of 80.8% (223/276 ),a specificity of 89.8% (255/284)and an accuracy of 70.6%,with a false positive rate of 10.2%(29/284)and a false negative rate of 19.2%(53/276);The vaginal secretion smear microscopy had a sensitivity of 63.0% (174/276),a specificity of 95.1%(270/284)and an accuracy of 58.1%,with a false positive rate of 4.9%(14/284)and a false negative rate of 37.0%(102/276).Compared with pH test paper method or vaginal secretion smear microscopy,IGFBP-1 detection resulted in an increase in sensitivity,specificity and accuracy and a decrease in false positive rate and false negative rate(all P <0.05).Conclusion IGFBP-1 detection is more accurate and sensitive than pH test paper method and vaginal secretion smear microscopy for diagnosing PROM,especially for diagnosing minor rupture of membranes.There-fore,GFBP-1 detection has clinical and practical value in the diagnosis of PROM.%目的:探讨胰岛素样生长因子结合蛋白-1诊断胎膜早破的临床价值。方法采用阴道分泌物涂片镜检、pH 试纸法、胰岛素样生长因子结合蛋白-1检测法检测276例胎膜早破患者(胎膜早破组)和284例行孕期体检的孕妇(

  5. [Exceptional iatrogenic ureteral rupture].

    Science.gov (United States)

    Martínez-Vieira, Almudena; Valera-Sánchez, Zoraida; Sousa-Vaquero, José María; Palacios-González, Carmen; García-Poley, Antonio; Bernal-Bellido, Carmen; Alamo-Martínez, José María; Millán-López, Ana; Blanco-Domínguez, Manuel; Galindo-Galindo, Antonio

    2005-08-01

    Rupture of the ureter is an infrequent event that can have serious consequences. The most frequent cause is surgical iatrogenic ureter disease. Other possible causes are urological procedures and urographic studies. In our patient, which, to our knowledge, is the first to be reported in the literature, the ureteral rupture was produced by a traumatic urinary catheterism, because the balloon was filled inside the ureter. The normal presentation is nephritic colic, although acute abdomen is also a possibility. The possibility of ureteral rupture in abdominopelvic surgery or in urological techniques should be evaluated when patients present these clinical symptoms. Treatment is surgical, although in some cases conservative measures can be used.

  6. Ruptured episiotomia resutured primarily.

    Science.gov (United States)

    Monberg, J; Hammen, S

    1987-01-01

    In a randomized study, 35 patients with ruptured episiotomy were treated in two ways. One group, treated with Clindamycin and primary resuture, did better than the other group, not resutured but spontaneously healed.

  7. Achilles tendon rupture - aftercare

    Science.gov (United States)

    Heel cord tear; Calcaneal tendon rupture ... MRI scan to see what type of Achilles tendon tear you have. An MRI is a type ... partial tear means at least some of the tendon is still OK. A full tear means your ...

  8. Spontaneous uterine rupture

    African Journals Online (AJOL)

    After ultrasound scan, uterine rupture was diagnosed and an ... delivery. The birth weights ranged between 2900 and 3200g. The last 2 .... abdominal pains and signs of shock, at which made up of altered blood and we think that the.

  9. Distal Biceps Tendon Rupture

    Science.gov (United States)

    2010-06-01

    distal tendon . Although these findings overlap with those seen in tendinopathy , the presence of bone marrow edema at the radial tuberosity and fluid in...the bicipitoradial bursa suggests a partial tear rather than tendinopathy .3 When the distal biceps tendon tear is complete, MR imaging shows...Distal Biceps Tendon Rupture Military Medicine Radiology Corner, 2006 Radiology Corner Distal Biceps Tendon Rupture Contributors: CPT Michael

  10. Ground-motion signature of dynamic ruptures on rough faults

    Science.gov (United States)

    Mai, P. Martin; Galis, Martin; Thingbaijam, Kiran K. S.; Vyas, Jagdish C.

    2016-04-01

    Natural earthquakes occur on faults characterized by large-scale segmentation and small-scale roughness. This multi-scale geometrical complexity controls the dynamic rupture process, and hence strongly affects the radiated seismic waves and near-field shaking. For a fault system with given segmentation, the question arises what are the conditions for producing large-magnitude multi-segment ruptures, as opposed to smaller single-segment events. Similarly, for variable degrees of roughness, ruptures may be arrested prematurely or may break the entire fault. In addition, fault roughness induces rupture incoherence that determines the level of high-frequency radiation. Using HPC-enabled dynamic-rupture simulations, we generate physically self-consistent rough-fault earthquake scenarios (M~6.8) and their associated near-source seismic radiation. Because these computations are too expensive to be conducted routinely for simulation-based seismic hazard assessment, we thrive to develop an effective pseudo-dynamic source characterization that produces (almost) the same ground-motion characteristics. Therefore, we examine how variable degrees of fault roughness affect rupture properties and the seismic wavefield, and develop a planar-fault kinematic source representation that emulates the observed dynamic behaviour. We propose an effective workflow for improved pseudo-dynamic source modelling that incorporates rough-fault effects and its associated high-frequency radiation in broadband ground-motion computation for simulation-based seismic hazard assessment.

  11. Lifestyle influences on prematurity.

    Science.gov (United States)

    Creasy, R K

    1991-01-01

    It is apparent from this review that the lifestyle of an individual gravida can potentially lead to a premature delivery. Some of these adverse behavioral characteristics may be dealt with by education and motivation, and some with actual medical treatment. However, there also appears to be significant need for public policy reorientation if we are to make a significant impact on the problem of preterm delivery.

  12. Rupture, waves and earthquakes

    Science.gov (United States)

    UENISHI, Koji

    2017-01-01

    Normally, an earthquake is considered as a phenomenon of wave energy radiation by rupture (fracture) of solid Earth. However, the physics of dynamic process around seismic sources, which may play a crucial role in the occurrence of earthquakes and generation of strong waves, has not been fully understood yet. Instead, much of former investigation in seismology evaluated earthquake characteristics in terms of kinematics that does not directly treat such dynamic aspects and usually excludes the influence of high-frequency wave components over 1 Hz. There are countless valuable research outcomes obtained through this kinematics-based approach, but “extraordinary” phenomena that are difficult to be explained by this conventional description have been found, for instance, on the occasion of the 1995 Hyogo-ken Nanbu, Japan, earthquake, and more detailed study on rupture and wave dynamics, namely, possible mechanical characteristics of (1) rupture development around seismic sources, (2) earthquake-induced structural failures and (3) wave interaction that connects rupture (1) and failures (2), would be indispensable. PMID:28077808

  13. Rupture, waves and earthquakes.

    Science.gov (United States)

    Uenishi, Koji

    2017-01-01

    Normally, an earthquake is considered as a phenomenon of wave energy radiation by rupture (fracture) of solid Earth. However, the physics of dynamic process around seismic sources, which may play a crucial role in the occurrence of earthquakes and generation of strong waves, has not been fully understood yet. Instead, much of former investigation in seismology evaluated earthquake characteristics in terms of kinematics that does not directly treat such dynamic aspects and usually excludes the influence of high-frequency wave components over 1 Hz. There are countless valuable research outcomes obtained through this kinematics-based approach, but "extraordinary" phenomena that are difficult to be explained by this conventional description have been found, for instance, on the occasion of the 1995 Hyogo-ken Nanbu, Japan, earthquake, and more detailed study on rupture and wave dynamics, namely, possible mechanical characteristics of (1) rupture development around seismic sources, (2) earthquake-induced structural failures and (3) wave interaction that connects rupture (1) and failures (2), would be indispensable.

  14. Teflon-buttressed sutures plus pericardium patch repair left ventricular rupture caused by radiofrequency catheter ablation

    Science.gov (United States)

    Cao, Hao; Zhang, Qi; He, Yanzhong; Feng, Xiaodong; Liu, Zhongmin

    2016-01-01

    Abstract Background: Cardiac rupture often occurs after myocardial infarction or chest trauma with a high mortality rate. However, left ventricular rupture caused by radiofrequency catheter ablation (RFCA) is extremely rare. Methods: We describe a case of a 61-year-old male who survived from left ventricular rupture caused by a RFCA procedure for frequent ventricular premature contractions. Surgical exploration with cardiopulmonary bypass (CPB) was performed when the signs of cardiac tamponade developed 7 hours after the ablation surgery. Results: Teflon-buttressed sutures of the tear in the left ventricular posterolateral wall and pericardium patch applied to the contusion region on the wall repaired the rupture safely and effectively. Conclusion: Timely surgical intervention under CPB facilitated the survival of the patient. Teflon-buttressed sutures plus pericardium patch achieved the successful repair of the rupture. PMID:27661047

  15. Complete Achilles tendon ruptures.

    Science.gov (United States)

    Landvater, S J; Renström, P A

    1992-10-01

    Achilles tendon ruptures can be treated nonsurgically in the nonathletic or low-end recreational athletic patient, particularly those more than 50 years of age, provided the treating physician does not delay in the diagnosis and treatment (preferably less than 48 hrs and possibly less than 1 week). The patient should be advised of the higher incidence of re-rupture of the tendon when treated nonsurgically. Surgical treatment is recommended for patients who are young and athletic. This is particularly true because the major criticism of surgical treatment has been the complication rate, which has decreased to a low level and to a mild degree, usually not significantly affecting the repair over time. Surgical treatment in these individuals seems to be superior not only in regard to re-rupture but also in assuring the correct apposition of the tendon ends and in placing the necessary tension on the tendon to secure appropriate orientation of the collagen fibers. This in turn allows them to regain full strength, power, endurance, and an early return to sports. Surgery is also recommended for late diagnosed ruptures where there is significant lengthening of the tendon. Surgical technique should involve a medial incision to avoid the sural nerve, absorbable suture, and augmentation with fascia or tendon where there is a gap or late rupture. Postoperatively, the immobilization should be 7 to 10 days in a splint. A walking boot with early motion in plantar flexion or a short leg cast with the tendon under slight tension should thereafter be used for 4 to 5 weeks. An early and well-supervised rehabilitation program should be initiated to restore the patient to the preinjury activity level.

  16. Rupture of the plantar fascia.

    Science.gov (United States)

    Pai, V S

    1996-01-01

    Rupture of the plantar fascia in athletes engaged in sports that require running and jumping has been reported. However, spontaneous degenerative rupture of the plantar fascia is not well documented in the literature. This paper reports a patient with degenerative rupture of the plantar fascia.

  17. Ruptured Giant Omphalocele. A Case Report

    Directory of Open Access Journals (Sweden)

    Víctor Manuel González Valdez

    2013-10-01

    Full Text Available Omphalocele is one of the abdominal wall defects. It can be associated with other malformations including imperforate anus, agenesis of the colon, bladder exstrophy and cardiovascular disease, frequently leading to non-viable fetuses. A case of a female newborn who was prematurely delivered (35.3 weeks in Belize with low birth weight (1860 g is presented. This first-born child required emergency surgery at ten hours of life for ruptured giant omphalocele associated with tetralogy of Fallot, hypoglycemia, and severe general malaise. The aim of this report is to present the diagnostic and therapeutic procedures in such cases. Given the appropriate prenatal diagnosis implemented in Cuba, it is unusual for Cuban doctors, except those working abroad, to treat these patients; hence, this paper may be useful in the teaching context.

  18. Premature aging syndrome.

    Science.gov (United States)

    Coppedè, Fabio

    2012-01-01

    Hutchinson-Gilford progeria syndrome and Werner syndrome are two of the best characterized human progeroid diseases with clinical features mimicking physiological aging at an early age. Both disorders have been the focus of intense research in recent years since they might provide insights into the pathology of normal human aging. The chapter contains a detailed description of the clinical features of both disorders and then it focuses on the genetics, the resulting biochemical alterations at the protein level and the most recent findings and hypotheses concerning the molecular basis of the premature aging phenotypes. A description of available diagnostic and therapeutic approaches is included.

  19. Rupture of Renal Transplant

    Directory of Open Access Journals (Sweden)

    Shona Baker

    2015-01-01

    Full Text Available Background. Rupture of renal allograft is a rare and serious complication of transplantation that is usually attributed to acute rejection, acute tubular necrosis, or renal vein thrombosis. Case Presentation. LD, a 26-year-old male with established renal failure, underwent deceased donor transplantation using kidney from a 50-year-old donor with acute kidney injury (Cr 430 mmol/L. LD had a stormy posttransplant recovery and required exploration immediately for significant bleeding. On day three after transplant, he developed pain/graft swelling and another significant haemorrhage with cardiovascular compromise which did not respond to aggressive resuscitation. At reexploration, the renal allograft was found to have a longitudinal rupture and was removed. Histology showed features of type IIa Banff 97 acute vascular rejection, moderate arteriosclerosis, and acute tubular necrosis. Conclusion. Possible ways of avoiding allograft rupture include use of well-matched, good quality kidneys; reducing or managing risk factors that would predispose to delayed graft function; ensuring a technically satisfactory transplant procedure with short cold and warm ischemia times; and avoiding large donor-recipient age gradients.

  20. Premature ovarian failure.

    Science.gov (United States)

    Shelling, Andrew N

    2010-11-01

    Premature ovarian failure (POF) is a common cause of infertility in women, and is characterised by amenorrhoea, hypo-oestrogenism and elevated gonadotrophin levels in women under the age of 40. Known causes include iatrogenic agents that cause permanent damage to the ovaries, such as chemotherapy, radiation therapy and surgery, autoimmune conditions, X-chromosome abnormalities and autosomal genetic conditions. However, few genes have been identified that can explain a substantial proportion of cases of POF. Most women with POF are deeply upset by the diagnosis, partly due to the unexpected menopausal symptoms, but also due to infertility. Therefore, early detection would provide better opportunity for early intervention, and furthermore, the identification of specific gene defects will help to direct potential targets for future treatment.

  1. Apnea of prematurity

    Directory of Open Access Journals (Sweden)

    Piermichele Paolillo

    2013-06-01

    Full Text Available Apnea of prematurity (AOP is one of the most frequent pathologies in the Neonatal Intensive Care Unit, with an incidence inversely related to gestational age. Its etiology is often multi factorial and diagnosis of idiopathic forms requires exclusion of other underlying diseases. Despite being a self-limiting condition which regresses with the maturation of the newborn, possible long-term effects of recurring apneas and the degree of desaturation and bradycardia who may lead to abnormal neurological outcome are not yet clarified. Therefore AOP needs careful evaluation of its etiology and adequate therapy that can be both pharmacological and non-pharmacological. Proceedings of the 9th International Workshop on Neonatology · Cagliari (Italy · October 23rd-26th, 2013 · Learned lessons, changing practice and cutting-edge research

  2. Premature ejaculation: A review

    Directory of Open Access Journals (Sweden)

    Sukumar Reddy Gajjala

    2014-01-01

    Full Text Available Premature ejaculation (PE is a common male sexual disorder. It is defined by the Diagnostic and statistical manual of mental disorders as "ejaculation occurring, without control, on or shortly after penetration and before the person wishes it, causing marked distress or interpersonal difficulty. [1] Although the timing of intravaginal ejaculatory latency time (IELT (i.e., time from penetration to ejaculation is not included in this definition, an IELT of <2 min, or ejaculation occurring before penetration, has been considered consistent with PE. [2] Management involves both the patient and his partner. Therapeutic options should suit both partners and be appropriate to their habit in planning and frequency of intercourse. Follow-up at appropriate intervals to judge efficacy, titrate dosage of pharmacological treatments and ascertain side effects is mandatory.

  3. Apnea of Prematurity (For Parents)

    Science.gov (United States)

    ... other babies. The apnea of prematurity does not cause brain damage. A healthy baby who is apnea free for a week will probably never have AOP again. Although sudden infant death syndrome (SIDS) does happen more often in premature infants, no relationship between AOP and SIDS has ...

  4. Delivery of a baby with severe combined immunodeficiency at 31 weeks gestation following an extreme preterm prelabour spontaneous rupture of the membranes: a case report

    Science.gov (United States)

    2009-01-01

    Introduction If left untreated, severe combined immunodeficiency can lead to an acute susceptibility to infection. The intrauterine environment is sterile until the amniotic membranes rupture. The vaginal flora then ascends into the genital tract, thus increasing the risk of chorioamnionitis. An extremely premature and prolonged membrane rupture is associated with a dismal prognosis for an immunocompetent preterm fetus. There are no case reports to date that detail the outcome of an immunocompromised preterm baby following prolonged rupture of membranes. Case presentation We present the case of a 32-year-old Indian woman who delivered a 31-week gestational baby who had a severe combined immunodeficiency following premature prelabour prolonged rupture of the membranes at the 14th week of gestation. Conclusion Extreme preterm prelabour spontaneous rupture of membranes in an underlying condition of severe combined immunodeficiency does not necessarily lead to an unfavourable outcome. PMID:19946536

  5. Delivery of a baby with severe combined immunodeficiency at 31 weeks gestation following an extreme preterm prelabour spontaneous rupture of the membranes: a case report

    Directory of Open Access Journals (Sweden)

    Watkinson Sally J

    2009-11-01

    Full Text Available Abstract Introduction If left untreated, severe combined immunodeficiency can lead to an acute susceptibility to infection. The intrauterine environment is sterile until the amniotic membranes rupture. The vaginal flora then ascends into the genital tract, thus increasing the risk of chorioamnionitis. An extremely premature and prolonged membrane rupture is associated with a dismal prognosis for an immunocompetent preterm fetus. There are no case reports to date that detail the outcome of an immunocompromised preterm baby following prolonged rupture of membranes. Case presentation We present the case of a 32-year-old Indian woman who delivered a 31-week gestational baby who had a severe combined immunodeficiency following premature prelabour prolonged rupture of the membranes at the 14th week of gestation. Conclusion Extreme preterm prelabour spontaneous rupture of membranes in an underlying condition of severe combined immunodeficiency does not necessarily lead to an unfavourable outcome.

  6. Prenatal Stress, Prematurity, and Asthma.

    Science.gov (United States)

    Medsker, Brock; Forno, Erick; Simhan, Hyagriv; Celedón, Juan C

    2015-12-01

    Asthma is the most common chronic disease of childhood, affecting millions of children in the United States and worldwide. Prematurity is a risk factor for asthma, and certain ethnic or racial minorities such as Puerto Ricans and non-Hispanic blacks are disproportionately affected by both prematurity and asthma. In this review, we examine current evidence to support maternal psychosocial stress as a putative link between prematurity and asthma, while also focusing on disruption of the hypothalamic-pituitary-adrenal (HPA) axis and immune responses as potential underlying mechanisms for stress-induced "premature asthma." Prenatal stress may cause not only abnormalities in the HPA axis but also epigenetic changes in the fetal glucocorticoid receptor gene (NR3C1), leading to impaired glucocorticoid metabolism. Moreover, maternal stress can alter fetal cytokine balance, favoring TH2 (allergic) immune responses characteristic of atopic asthma: interleukin 6 (IL-6), which has been associated with premature labor, can promote TH2 responses by stimulating production of IL-4 and IL-13. Given a link among stress, prematurity, and asthma, future research should include birth cohorts aimed at confirming and better characterizing "premature asthma." If confirmed, clinical trials of prenatal maternal stress reduction would be warranted to reduce the burden of these common comorbidities. While awaiting the results of such studies, sound policies to prevent domestic and community violence (eg, from firearms) are justified, not only by public safety but also by growing evidence of detrimental effects of violence-induced stress on psychiatric and somatic health.

  7. A case of testicular rupture

    OpenAIRE

    野俣, 浩一郎; 林, 幹男

    1987-01-01

    A case of testicular rupture is reported. A 26-year-old man was referred to our hospital because of testicular trauma. Ultrasound of the testis was performed preoperatively. Ultrasonography revealed a disruption of the tunica albuginea and dense clusters of echoes in the tunica vaginalis. In the case of acute testicular trauma, this echo pattern suggests testicular rupture.

  8. Premature ovarian failure

    Directory of Open Access Journals (Sweden)

    Vujović Svetlana

    2012-01-01

    Full Text Available Premature ovarian failure (POF is the occurrence of hypergonadotropic hypoestrogenic amenorrhea in women under the age of forty years. It is idiopathic in 74-90% patients. Known cases can be divided into primary and secondary POF. In primary POF genetic aberrations can involve the X chromosome (monosomy, trisomy, translocations, deletions or autosomes. Genetic mechanisms include reduced gene dosage and non-specific chromosome effects impairing meiosis, decreasing the pool of primordial follicles and increasing atresia due to apoptosis or failure of follicle maturation. Autoimmune ovarian damage is caused by alteration of T-cell subsets and T-cell mediated injury, increase of autoantibody producing B-cells, a low number of effector/cytotoxic lymphocyte, which decreases the number and activity of natural killer cells. Bilateral oophorectomy, chemotherapy, radiotherapy and infections cause the secondary POF. Symptoms of POF include irritability, nervousness, loss of libido, depression, lack of concentration, hot flushes, weight gaining, dry skin, vaginal dryness, frequent infections etc. The diagnosis is confirmed by the level of FSH of over 40 IU/L and estradiol below 50 pmol/L in women aged below 40 years. Biochemical and other hormonal analysis (free thyroxin, TSH, prolactin, testosterone, karyotype (<30 years of age, ultrasound of the breasts and pelvis are advisable. Optimal therapy is combined estrogen progestagen therapy given in a sequential rhythm, after excluding absolute contraindications. Testosterone can be added to adnexectomized women and those with a low libido. Sequential estrogen progestagen replacement therapy is the first line therapy for ovulation induction in those looking for pregnancy and after that oocyte donation will be advised. Appropriate estro-progestagen therapy improves the quality of life and prevents complications such as cardiovascular diseases, osteoporosis, stroke etc.

  9. Splenic rupture following colonoscopy

    Institute of Scientific and Technical Information of China (English)

    Juan Francisco Guerra; Ignacio San Francisco; Fernando Pimentel; Luis Ibanez

    2008-01-01

    Colonoscopy is a safe and routinely performed diagnostic and therapeutic procedure for different colorectal diseases. Although the most common complications are bleeding and perforation, extracolonic or visceral injuries have also been described. Splenic rupture is a rare complication following colonoscopy, with few cases reported. We report a 60-year-old female who presented to surgical consultation 8 h after a diagnostic colonoscopy. Clinical, laboratory and imaging findings were suggestive for a massive hemoperitoneum. At surgery, an almost complete splenic disruption was evident, and an urgent splenectomy was performed. After an uneventful postoperative period, she was discharged home. Splenic injury following colonoscopy is considered infrequent. Direct trauma and excessive traction of the splenocolic ligament can explain the occurrence of this complication. Many times the diagnosis is delayed because the symptoms are due to colonic insufflation, so the most frequent treatment is an urgent splenectomy. A high index of suspicion needs an early diagnosis and adequate therapy.

  10. Blunt traumatic diaphragmatic rupture

    Directory of Open Access Journals (Sweden)

    Antonio Carlos Nogueira

    2011-09-01

    Full Text Available Traumatic injury of the diaphragm ranges from 0.6 to 1.2% and rise up to 5%among patients who were victims of blunt trauma and underwent laparotomy.Clinical suspicion associated with radiological assessment contributes to earlydiagnosis. Isolated diaphragmatic injury has a good prognosis. Generallyworse outcomes are associated with other trauma injuries. Bilateral andright diaphragmatic lesions have worse prognosis. Multi detector computed tomography (MDCT scan of the chest and abdomen provides better diagnosticaccuracy using the possibility of image multiplanar reconstruction. Surgicalrepair via laparotomy and/ or thoracotomy in the acute phase of the injury hasa better outcome and avoids chronic complications of diaphragmatic hernia.The authors present the case of a young male patient, victim of blunt abdominaltrauma due to motor vehicle accident with rupture of the diaphragm, spleenand kidney injuries. The diagnosis was made by computed tomography of thethorax and abdomen and was confirmed during laparotomy.

  11. Spontaneous Rupture of Pyometra

    Directory of Open Access Journals (Sweden)

    Fatemeh Mallah

    2013-01-01

    Full Text Available Spontaneous perforation is a very rare complication of pyometra. The clinical findings of perforated pyometra are similar to perforation of the gastrointestinal tract and other causes of acute abdomen. In most cases, a correct and definite diagnosis can be made only by laparotomy. We report two cases of diffuse peritonitis caused by spontaneous perforated pyometra. The first case is a 78-year-old woman with abdominal pain for which laparotomy was performed because of suspected incarcerated hernia. The second case is a 61-year-old woman with abdominal pain for which laparotomy was performed because of symptoms of peritonitis. At laparotomy of both cases, 1 liter of pus with the source of uterine was found in the abdominal cavity. The ruptured uterine is also detected. More investigations revealed no malignancy as the reason of the pyometra.

  12. Spontaneous Rupture of Pyometra

    Science.gov (United States)

    Mallah, Fatemeh; Eftekhar, Tahere; Naghavi-Behzad, Mohammad

    2013-01-01

    Spontaneous perforation is a very rare complication of pyometra. The clinical findings of perforated pyometra are similar to perforation of the gastrointestinal tract and other causes of acute abdomen. In most cases, a correct and definite diagnosis can be made only by laparotomy. We report two cases of diffuse peritonitis caused by spontaneous perforated pyometra. The first case is a 78-year-old woman with abdominal pain for which laparotomy was performed because of suspected incarcerated hernia. The second case is a 61-year-old woman with abdominal pain for which laparotomy was performed because of symptoms of peritonitis. At laparotomy of both cases, 1 liter of pus with the source of uterine was found in the abdominal cavity. The ruptured uterine is also detected. More investigations revealed no malignancy as the reason of the pyometra. PMID:24024054

  13. Teflon-buttressed sutures plus pericardium patch repair left ventricular rupture caused by radiofrequency catheter ablation: A case report.

    Science.gov (United States)

    Cao, Hao; Zhang, Qi; He, Yanzhong; Feng, Xiaodong; Liu, Zhongmin

    2016-09-01

    Cardiac rupture often occurs after myocardial infarction or chest trauma with a high mortality rate. However, left ventricular rupture caused by radiofrequency catheter ablation (RFCA) is extremely rare. We describe a case of a 61-year-old male who survived from left ventricular rupture caused by a RFCA procedure for frequent ventricular premature contractions. Surgical exploration with cardiopulmonary bypass (CPB) was performed when the signs of cardiac tamponade developed 7 hours after the ablation surgery. Teflon-buttressed sutures of the tear in the left ventricular posterolateral wall and pericardium patch applied to the contusion region on the wall repaired the rupture safely and effectively. Timely surgical intervention under CPB facilitated the survival of the patient. Teflon-buttressed sutures plus pericardium patch achieved the successful repair of the rupture.

  14. Preterm labor and premature birth: Are you at risk?

    Science.gov (United States)

    ... labor and premature birth: Are you at risk? Preterm labor and premature birth: Are you at risk? ... for preterm labor and premature birth. What are preterm labor and premature birth? Preterm and premature mean ...

  15. Mechanics of cutaneous wound rupture.

    Science.gov (United States)

    Swain, Digendranath; Gupta, Anurag

    2016-11-07

    A cutaneous wound may rupture during healing as a result of stretching in the skin and incompatibility at the wound-skin interface, among other factors. By treating both wound and skin as hyperelastic membranes, and using a biomechanical framework of interfacial growth, we study rupturing as a problem of cavitation in nonlinear elastic materials. We obtain analytical solutions for deformation and residual stress field in the skin-wound configuration while emphasizing the coupling between wound rupture and wrinkling in the skin. The solutions are analyzed in detail for variations in stretching environment, healing condition, and membrane stiffness.

  16. 产前备皮方式的临床对照研究%Clinical control study in methods of pre-labor pubic preparation

    Institute of Scientific and Technical Information of China (English)

    张宏玉; 韩月清; 王小环; 王青; 黄敏

    2008-01-01

    Objective To determine whether it is necessary to execute pre-labor pubic shaving.Methods Women(336 cases)who received pubic shaving through vaginal delivery from 2003 to 2006 were set as the control group.Women(103 cases)who were waiting for delivery currently in our hospital were set as the test group.The test group only received perineal cleaning without pubic shaving.If episiotomy was needed during the operation,the perineal hair Was cut by scissors.The perineum infectious rate and postpartal infection Was compared in the two groups.We interviewed the patients attitude for pubic shaving and counted the numing time used for pubic shaving.Results The perineal infection in the test group was 5.8%,which was no statistically different from that of the control group(2.4%),U=0.33,P>0.05.Totally 95% women in the test group support this method demonstrated humanization.In the telephone folow-up visit for patients in the control group they comphined itch and discomfort during the regeneration of pubes.The average numing time for pubic shaving Was(4.6±0.6)minutes.Conclusions No pubic shaving for pre-labor skin preparation was feasible.If operation was disturbed by pubes we could use scissors to cut it short.This method could reduce the skin infection and propagation of blood-derived infectious disease.It increased the comfort of parturient,saved time and proved to be a nursing method of humanization.%目的 确定产前备皮时是否需要剃除阴毛.方法 开展临床对照研究,将2003-2006年经阴道分娩产前剃除阴毛的产妇336例作为对照组,以目前待产的产妇103例作为实验组.实验组产前备皮时只清洁会阴,不剃除阴毛,如需要行会阴切开术,在术前用剪刀将手术区阴毛剪短.比较2组会阴感染率及产褥感染率.并通过访谈了解2组产妇对此措施的主观感受.计算备皮剃除阴毛时所用护理时间.结果 实验组会阴感染率为5.8%,对照组会阴感染率为2.4%,2组比

  17. Elbow tendinopathy and tendon ruptures: epicondylitis, biceps and triceps ruptures.

    Science.gov (United States)

    Rineer, Craig A; Ruch, David S

    2009-03-01

    Lateral and medial epicondylitis are common causes of elbow pain in the general population, with the lateral variety being more common than the medial by a ratio reportedly ranging from 4:1 to 7:1. Initially thought to be an inflammatory condition, epicondylitis has ultimately been shown to result from tendinous microtearing followed by an incomplete reparative response. Numerous nonoperative and operative treatment options have been employed in the treatment of epicondylitis, without the emergence of a single, consistent, universally accepted treatment protocol. Tendon ruptures about the elbow are much less frequent, but result in more significant disability and loss of function. Distal biceps tendon ruptures typically occur in middle-aged males as a result of an event that causes a sudden, eccentric contraction of the biceps. Triceps tendon ruptures are exceedingly rare but usually have a similar etiology with a forceful eccentric contraction of the triceps that causes avulsion of the tendon from the olecranon. The diagnosis of these injuries is not always readily made. Complete ruptures of the biceps or triceps tendons have traditionally been treated surgically with good results. With regard to biceps ruptures, there continues to be debate about the best surgical approach, as well as the best method of fixation of tendon to bone. This article is not meant to be an exhaustive review of the broad topics of elbow tendinopathy and tendon ruptures, but rather is a review of recently published information on the topics that will assist the clinician in diagnosis and management of these conditions.

  18. Ruptured thought: rupture as a critical attitude to nursing research.

    Science.gov (United States)

    Beedholm, Kirsten; Lomborg, Kirsten; Frederiksen, Kirsten

    2014-04-01

    In this paper, we introduce the notion of ‘rupture’ from the French philosopher Michel Foucault, whose studies of discourse and governmentality have become prominent within nursing research during the last 25 years. We argue that a rupture perspective can be helpful for identifying and maintaining a critical potential within nursing research. The paper begins by introducing rupture as an inheritance from the French epistemological tradition. It then describes how rupture appears in Foucault's works, as both an overall philosophical approach and as an analytic tool in his historical studies. Two examples of analytical applications of rupture are elaborated. In the first example, rupture has inspired us to make an effort to seek alternatives to mainstream conceptions of the phenomenon under study. In the second example, inspired by Foucault's work on discontinuity, we construct a framework for historical epochs in nursing history. The paper concludes by discussing the potential of the notion of rupture as a response to the methodological concerns regarding the use of Foucault-inspired discourse analysis within nursing research. We agree with the critique of Cheek that the critical potential of discourse analysis is at risk of being undermined by research that tends to convert the approach into a fixed method.

  19. Surgical experience of the ruptured distal anterior cerebral artery aneurysms.

    Science.gov (United States)

    Lee, Jong-Young; Kim, Moon-Kyu; Cho, Byung-Moon; Park, Se-Hyuck; Oh, Sae-Moon

    2007-10-01

    Distal anterior cerebral artery (DACA) aneurysms are fragile and known to have high risks for intraoperative premature rupture and a relatively high associated morbidity. To improve surgical outcomes of DACA aneurysms, we reviewed our surgical strategy and its results postoperatively. A total of 845 patients with ruptured cerebral aneurysms were operated in our hospital from January 1991 to December 2005. Twenty-three of 845 patients had ruptured DACA aneurysms which were operated on according to our surgical strategy. Our surgical strategy was as follows; early surgery, appropriate releasing of CSF, appropriate surgical approach, using neuronavigating system, securing the bridging veins, using temporary clipping and/or tentative clipping, meticulous manipulation of aneurysm, and using micro-Doppler flow probe. Twenty of 23 patients who had complete medical records were studied retrospectively. We observed the postoperative radiographic findings and checked Glasgow Outcome Scale score sixth months after the operation. Nineteen DACA aneurysms were clipped through a unilateral interhemispheric approach and one DACA aneurysm was clipped through a pterional approach. Postoperative radiographic findings revealed complete clipping of aneurysmal neck without stenosis or occlusion of parent arteries. In two patients, a residual neck of aneurysm was visualized. Seventeen patients showed good recovery, one patient resulted in moderate disability, while 2 patients died. With our surgical strategy it was possible to achieve acceptable surgical morbidity and mortality rates in patients with DACA aneurysms. Appropriate use of tentative clipping, temporary clipping and neuro-navigating systems can give great help for safe approach and clipping of DACA aneurysm.

  20. Spontaneous rupture of unscarred gravid uterus.

    Science.gov (United States)

    Gurudut, Kolala S; Gouda, Hareesh S; Aramani, Sunil C; Patil, Raju H

    2011-01-01

    Rupture of gravid uterus during pregnancy is a rare entity. Overall incidence of rupture of uterus during pregnancy is 0.07%. The maternal and fetal prognoses are bad especially when the rupture occurs in an unscarred uterus. Fortunately, the sole major risk factor of spontaneous rupture of unscarred uterus is preventable, which is "multiparity." In this article, we report the death of a pregnant woman and her unborn child because of spontaneous rupture of unscarred uterus.

  1. Your Premature Baby: Low Birthweight

    Science.gov (United States)

    ... many low-birthweight babies are born prematurely, many risk factors for having a low-birthweight baby are the same for preterm labor and ... risk for having a low-birthweight baby. Medical risk factors for having a low-birthweight baby Preterm labor . This is labor that starts ...

  2. Music Therapy with Premature Infants

    Science.gov (United States)

    Standley, Jayne

    2003-01-01

    Over 20 years of research and clinical practice in music therapy with premature infants has been compiled into this text designed for Board Certified Music Therapists specializing in Neonatal Intensive Care clinical services, for NICU medical staff incorporating research-based music therapy into developmental care plans, and for parents of…

  3. Music Therapy with Premature Infants

    Science.gov (United States)

    Standley, Jayne

    2003-01-01

    Over 20 years of research and clinical practice in music therapy with premature infants has been compiled into this text designed for Board Certified Music Therapists specializing in Neonatal Intensive Care clinical services, for NICU medical staff incorporating research-based music therapy into developmental care plans, and for parents of…

  4. MODERN PRODUCTS FOR FEEDING PREMATURE BABIES

    National Research Council Canada - National Science Library

    A. V. Surzhik

    2012-01-01

    .... Adequate feeding is one of the fundamental factors of premature babies nursing. To ensure a premature baby with all necessary components for power saving in breast milk intake, breast milk fortifiers...

  5. Quadriceps and patellar tendon rupture.

    Science.gov (United States)

    Ramseier, L E; Werner, C M L; Heinzelmann, M

    2006-06-01

    Ruptures of the patellar and/or quadriceps tendon are rare injuries that require immediate repair to re-establish knee extensor continuity and to allow early motion. We evaluated 36 consecutive patients with quadriceps or patellar tendon rupture between 1993 and 2000. There were 37 primary ruptures, 3 reruptures, 21 quadriceps and 19 patellar tendon ruptures. Follow up examination (>24 months postoperatively) included the patient's history, assessment of risk factors, clinical examination of both knees, isometric muscle strength measurements and three specific knee scores, Hospital for Special Surgery Score, Knee Society Score and Turba Score, and a short form SF-36. We evaluated 29 patients (26 men) with 33 ruptures (16 patellar tendon, 17 quadriceps tendon). Seven patients were lost to follow up. We found no difference between the range of motion and muscle strength when the injured leg was compared to the non-injured leg. Risk factors did not influence the four scores, patient satisfaction, pain, muscle strength or range of motion. Multiple injured patients had a significant reduction in muscle strength and circumference, however patient satisfaction did not differ to the non-multiple injured patient group.

  6. Outcomes for Extremely Premature Infants

    Science.gov (United States)

    Glass, Hannah C.; Costarino, Andrew T.; Stayer, Stephen A.; Brett, Claire; Cladis, Franklyn; Davis, Peter J.

    2015-01-01

    Premature birth is a significant cause of infant and child morbidity and mortality. In the United States, the premature birth rate, which had steadily increased during the 1990s and early 2000s, has decreased annually for four years and is now approximately 11.5%. Human viability, defined as gestational age at which the chance of survival is 50%, is currently approximately 23–24 weeks in developed countries. Infant girls, on average, have better outcomes than infant boys. A relatively uncomplicated course in the intensive care nursery for an extremely premature infant results in a discharge date close to the prenatal EDC. Despite technological advances and efforts of child health experts during the last generation, the extremely premature infant (less than 28 weeks gestation) and extremely low birth weight infant (ELBW) (premature labor improved neonatal mortality and morbidity in the late 1990s. The recognition that chronic postnatal administration of steroids to infants should be avoided may have improved outcomes in the early 2000s. Evidence from recent trials attempting to define the appropriate target for oxygen saturation in preterm infants suggests arterial oxygen saturation between 91–95% (compared to 85–89%) avoids excess mortality. However, final analyses of data from these trials have not been published, so definitive recommendations are still pending The development of neonatal neurocognitive care visits may improve neurocognitive outcomes in this high-risk group. Long-term follow up to detect and address developmental, learning, behavioral, and social problems is critical for children born at these early gestational ages. The striking similarities in response to extreme prematurity in the lung and brain imply that agents and techniques that benefit one organ are likely to also benefit the other. Finally, since therapy and supportive care continue to change, the outcomes of ELBW infants are ever evolving. Efforts to minimize injury, preserve

  7. Outcomes for extremely premature infants.

    Science.gov (United States)

    Glass, Hannah C; Costarino, Andrew T; Stayer, Stephen A; Brett, Claire M; Cladis, Franklyn; Davis, Peter J

    2015-06-01

    Premature birth is a significant cause of infant and child morbidity and mortality. In the United States, the premature birth rate, which had steadily increased during the 1990s and early 2000s, has decreased annually for 7 years and is now approximately 11.39%. Human viability, defined as gestational age at which the chance of survival is 50%, is currently approximately 23 to 24 weeks in developed countries. Infant girls, on average, have better outcomes than infant boys. A relatively uncomplicated course in the intensive care nursery for an extremely premature infant results in a discharge date close to the prenatal estimated date of confinement. Despite technological advances and efforts of child health experts during the last generation, the extremely premature infant (less than 28 weeks gestation) and extremely low birth weight infant (death and disability with 30% to 50% mortality and, in survivors, at least 20% to 50% risk of morbidity. The introduction of continuous positive airway pressure, mechanical ventilation, and exogenous surfactant increased survival and spurred the development of neonatal intensive care in the 1970s through the early 1990s. Routine administration of antenatal steroids during premature labor improved neonatal mortality and morbidity in the late 1990s. The recognition that chronic postnatal administration of steroids to infants should be avoided may have improved outcomes in the early 2000s. Evidence from recent trials attempting to define the appropriate target for oxygen saturation in preterm infants suggests arterial oxygen saturation between 91% and 95% (compared with 85%-89%) avoids excess mortality; however, final analyses of data from these trials have not been published, so definitive recommendations are still pending. The development of neonatal neurocritical intensive care units may improve neurocognitive outcomes in this high-risk group. Long-term follow-up to detect and address developmental, learning, behavioral, and

  8. Untreated silicone breast implant rupture

    DEFF Research Database (Denmark)

    Hölmich, Lisbet R; Vejborg, Ilse M; Conrad, Carsten

    2004-01-01

    Implant rupture is a well-known complication of breast implant surgery that can pass unnoticed by both patient and physician. To date, no prospective study has addressed the possible health implications of silicone breast implant rupture. The aim of the present study was to evaluate whether...... untreated ruptures are associated with changes over time in magnetic resonance imaging findings, serologic markers, or self-reported breast symptoms. A baseline magnetic resonance imaging examination was performed in 1999 on 271 women who were randomly chosen from a larger cohort of women having cosmetic...... breast implants for a median period of 12 years (range, 3 to 25 years). A follow-up magnetic resonance imaging examination was carried out in 2001, excluding women who underwent explantation in the period between the two magnetic resonance imaging examinations (n = 44). On the basis of these examinations...

  9. Protecting geothermal operations with rupture disks

    Energy Technology Data Exchange (ETDEWEB)

    Porter, D.W.

    1983-02-01

    Potential rupture disk applications in geothermal operations are reviewed. Several wells manifolded together, to form the geothermal feed, cause erratic pressure. Rupture disks are used for relief. Flash tanks are equipped with rupture disks. Brine separators, heat exchanger shells, and turbine casings are protected by rupture disks. An analysis of geothermal steam will determine the rupture disk metal. Reverse Buckling disks are recommended over tension loaded disks for dealing with geothermal pressure cycling. Erratic temperature suggests that metals which retain tensile strength with temperature be used (Inconel is mentioned). In summary, geothermal projects represent an excellent rupture disk market.

  10. Self-Rupturing Hermetic Valve

    Science.gov (United States)

    Tucker, Curtis E., Jr.; Sherrit, Stewart

    2011-01-01

    For commercial, military, and aerospace applications, low-cost, small, reliable, and lightweight gas and liquid hermetically sealed valves with post initiation on/off capability are highly desirable for pressurized systems. Applications include remote fire suppression, single-use system-pressurization systems, spacecraft propellant systems, and in situ instruments. Current pyrotechnic- activated rupture disk hermetic valves were designed for physically larger systems and are heavy and integrate poorly with portable equipment, aircraft, and small spacecraft and instrument systems. Additionally, current pyrotechnically activated systems impart high g-force shock loads to surrounding components and structures, which increase the risk of damage and can require additional mitigation. The disclosed mechanism addresses the need for producing a hermetically sealed micro-isolation valve for low and high pressure for commercial, aerospace, and spacecraft applications. High-precision electrical discharge machining (EDM) parts allow for the machining of mated parts with gaps less than a thousandth of an inch. These high-precision parts are used to support against pressure and extrusion, a thin hermetically welded diaphragm. This diaphragm ruptures from a pressure differential when the support is removed and/or when the plunger is forced against the diaphragm. With the addition of conventional seals to the plunger and a two-way actuator, a derivative of this design would allow nonhermetic use as an on/off or metering valve after the initial rupturing of the hermetic sealing disk. In addition, in a single-use hermetically sealed isolation valve, the valve can be activated without the use of potential leak-inducing valve body penetrations. One implementation of this technology is a high-pressure, high-flow-rate rupture valve that is self-rupturing, which is advantageous for high-pressure applications such as gas isolation valves. Once initiated, this technology is self

  11. Spontaneous rupture of vaginal enterocele

    DEFF Research Database (Denmark)

    Svendsen, Jesper Hastrup; Galatius, H; Hansen, P K

    1985-01-01

    Spontaneous rupture of an enterocele is a rare complication. Only 24 cases including the present case have been reported in the literature. The patients were elderly and had had at least one vaginal operation. The patients were remarkably unaffected symptomatically on admission.......Spontaneous rupture of an enterocele is a rare complication. Only 24 cases including the present case have been reported in the literature. The patients were elderly and had had at least one vaginal operation. The patients were remarkably unaffected symptomatically on admission....

  12. Spontaneous rupture of vaginal enterocele

    DEFF Research Database (Denmark)

    Svendsen, Jesper Hastrup; Galatius, H; Hansen, P K

    1985-01-01

    Spontaneous rupture of an enterocele is a rare complication. Only 24 cases including the present case have been reported in the literature. The patients were elderly and had had at least one vaginal operation. The patients were remarkably unaffected symptomatically on admission.......Spontaneous rupture of an enterocele is a rare complication. Only 24 cases including the present case have been reported in the literature. The patients were elderly and had had at least one vaginal operation. The patients were remarkably unaffected symptomatically on admission....

  13. Simultaneous bilateral patellar tendon rupture

    Directory of Open Access Journals (Sweden)

    Diogo Lino Moura

    Full Text Available ABSTRACT Bilateral patellar tendon rupture is a rare entity, often associated with systemic diseases and patellar tendinopathy. The authors report a rare case of a 34-year-old man with simultaneous bilateral rupture of the patellar tendon caused by minor trauma. The patient is a retired basketball player with no past complaints of chronic knee pain and a history of steroid use. Surgical management consisted in primary end-to-end tendon repair protected temporarily with cerclage wiring, followed by a short immobilization period and intensive rehabilitation program. Five months after surgery, the patient was able to fully participate in sport activities.

  14. MODERN PRODUCTS FOR FEEDING PREMATURE BABIES

    Directory of Open Access Journals (Sweden)

    A. V. Surzhik

    2012-01-01

    Full Text Available In recent decades there has been substantial progress in the technology of premature infants nursing, especially with extremely low birth weight. Adequate feeding is one of the fundamental factors of premature babies nursing. To ensure a premature baby with all necessary components for power saving in breast milk intake, breast milk fortifiers — specifically developed additives that adjust the composition of food for premature babies, are used for more than 20 years (for premature babies receiving breast milk. On the one hand, to preserve all benefits of breastfeeding, on the other — to prevent the deficit development of necessary elements for adequate growth and development of nutrients.

  15. [Forensic importance of premature craniosynostosis].

    Science.gov (United States)

    Fehlow, P

    1991-01-01

    In agreement with Canabis craniosynostosis as a little known organic partial factor of sociopathy is demonstrated. A psychic syndrome of the frontal lobe with increased susceptibility in environmental damages is assumed to be basic disorder. In the criminals of the material sexual offenders were preponderating. Associated craniofacial dysplasias are a risk for psychic maldevelopment. The importance of premature craniosynostocis as a biological risk factor, incidence, diagnostic, indication for an operation, also in the meaning of a neurosurgical "Konflikttherapie" (cosmetical indication) are discussed.

  16. Rupture of Achilles Tendon : Usefulness of Ultrasonography

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Nam Hyeon; Ki, Won Woo; Yoon, Kwon Ha; Kim, Song Mun; Shin, Myeong Jin [Ulsan Medical College, Ulsan (Korea, Republic of); Kwon, Soon Tae [Chungnam University College of Medicine, Daejeon (Korea, Republic of)

    1996-06-15

    To differentiate a complete rupture of Achilles tendon from an incomplete one which is important because its treatment is quite different. And it is necessary to know the exact site of the rupture preoperatively. Fifteen cases of fourteen patients which were diagnosed as Achilles tendon rupture by ultrasonography and surgery were reviewed. We compared sonographic rupture site with surgical findings. Ultrasonographic criteria for differentiation of complete and incomplete rupture was defined as follows : the discreteness, which means the proximal intervening hypoechogenicity to the interface echogenicity of distal margin of ruptured tendon : the slant sign, which represents the interface of ruptured distal margin which was seen over the 3/4 of the thickness of the tendon without intervening low echogeneicity : the invagination sign, which means the echogenic invagination from Kager triangle into posterior aspect of Achilles tendon over the half thickness of the tendon. The sites of complete tendon rupture were exactly corresponded to surgical finding in four cases of ten complete ruptures. And the discrepancy between sonographic and surgical findings in the site of complete rupture was 1.2 {+-} 0.4 cm in six cases. Three of ten complete ruptures showed the discreteness sign, all of ten showed the slant sign and two of ten showed the invagination sign. It is helpful to differentiate a complete from incomplete rupture of the Achilles tendon and to localize the site of the complete rupture with the ultrasonographic evaluation

  17. Antibiotics for preterm rupture of membranes.

    Science.gov (United States)

    Kenyon, Sara; Boulvain, Michel; Neilson, James P

    2013-12-02

    Premature birth carries substantial neonatal morbidity and mortality. Subclinical infection is associated with preterm rupture of membranes (PROM). Prophylactic maternal antibiotic therapy might lessen infectious morbidity and delay labour, but could suppress labour without treating underlying infection. To evaluate the immediate and long-term effects of administering antibiotics to women with PROM before 37 weeks, on maternal infectious morbidity, neonatal morbidity and mortality, and longer-term childhood development. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 September 2013). Randomised controlled trials comparing antibiotic administration with placebo that reported clinically relevant outcomes were included as were trials of different antibiotics. Trials in which no placebo was used were included for the outcome of perinatal death alone. We extracted data from each report without blinding of either the results or the treatments that women received. We sought unpublished data from a number of authors. We included 22 trials, involving 6872 women and babies.The use of antibiotics following PROM is associated with statistically significant reductions in chorioamnionitis (average risk ratio (RR) 0.66, 95% confidence interval (CI) 0.46 to 0.96, and a reduction in the numbers of babies born within 48 hours (average RR 0.71, 95% CI 0.58 to 0.87) and seven days of randomisation (average RR 0.79, 95% CI 0.71 to 0.89). The following markers of neonatal morbidity were reduced: neonatal infection (RR 0.67, 95% CI 0.52 to 0.85), use of surfactant (RR 0.83, 95% CI 0.72 to 0.96), oxygen therapy (RR 0.88, 95% CI 0.81 to 0.96), and abnormal cerebral ultrasound scan prior to discharge from hospital (RR 0.81, 95% CI 0.68 to 0.98). Co-amoxiclav was associated with an increased risk of neonatal necrotising enterocolitis (RR 4.72, 95% CI 1.57 to 14.23).One study evaluated the children's health at seven years of age (ORACLE Children Study) and found

  18. Achilles tendon rupture; assessment of nonoperative treatment

    National Research Council Canada - National Science Library

    Barfod, Kristoffer Weisskirchner

    2014-01-01

    Acute Achilles tendon rupture is a frequent and potentially disabling injury. Over the past decade a change in treatment of acute Achilles tendon rupture away from operative towards non-operative treatment has taken place...

  19. Spontaneous Splenic Rupture in Melanoma

    Directory of Open Access Journals (Sweden)

    Hadi Mirfazaelian

    2014-01-01

    Full Text Available Spontaneous rupture of spleen due to malignant melanoma is a rare situation, with only a few case reports in the literature. This study reports a previously healthy, 30-year-old man who came with chief complaint of acute abdominal pain to emergency room. On physical examination, abdominal tenderness and guarding were detected to be coincident with hypotension. Ultrasonography revealed mild splenomegaly with moderate free fluid in abdominopelvic cavity. Considering acute abdominal pain and hemodynamic instability, he underwent splenectomy with splenic rupture as the source of bleeding. Histologic examination showed diffuse infiltration by tumor. Immunohistochemical study (positive for S100, HMB45, and vimentin and negative for CK, CD10, CK20, CK7, CD30, LCA, EMA, and chromogranin confirmed metastatic malignant melanoma. On further questioning, there was a past history of a nasal dark skin lesion which was removed two years ago with no pathologic examination. Spontaneous (nontraumatic rupture of spleen is an uncommon situation and it happens very rarely due to neoplastic metastasis. Metastasis of malignant melanoma is one of the rare causes of the spontaneous rupture of spleen.

  20. Spontaneous bilateral quadriceps tendon rupture.

    Science.gov (United States)

    Vigneswaran, N; Lee, K; Yegappan, M

    2007-11-01

    Spontaneous bilateral quadriceps tendon ruptures are uncommon. We present a 30-year-old man with end-stage renal failure, who sustained this injury, and subsequently had surgical repair of both tendons on separate occasions. He has since regained full range of movement of both knees.

  1. The role of serum apelin in retinopathy of prematurity

    Directory of Open Access Journals (Sweden)

    Ali YF

    2017-02-01

    Full Text Available Yasser F Ali,1 Salah El-Morshedy,1 Abdulbasit Abdulhalim Imam,2 Nasser Ismai A Abdelrahman,1 Riad M Elsayed,3 Usama M Alkholy,1 Nermin Abdalmonem,1 Mohammed M Shehab1 1Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, 2Department of Pediatrics, Al-Azhar Faculty of Medicine-Girls, Cairo, 3Pediatric Neurology Unit, Pediatric Department, Mansoura University, Mansoura, Egypt Objective: To evaluate the role of serum apelin as a diagnostic tool in retinopathy of prematurity (ROP disease.Patients and methods: Thirty-eight preterm infants (60% male with gestational age ranging from 30 to 36 weeks admitted to the neonatal intensive care unit, KJO Hospital, Saudi Arabia with proven diagnosis of ROP were included in the study. In addition, 27 preterm infants without ROP served as controls. All newborn infants in the study were subjected to adequate history taking, full clinical examination, and fundus examination by indirect ophthalmoscope (at 4–6 weeks as well as determination of serum apelin at birth and at 4–6 weeks of age.Results: The study revealed that oxygen therapy longer than 7 days’ duration, cesarean section (as a mode of delivery, sepsis, mechanical ventilation, blood transfusion, premature rupture of membranes, pneumothorax, perinatal asphyxia, cardiac problems, and neonatal jaundice were considered as risk factors related to development of ROP. Serum apelin levels were significantly lower in patients than controls (P<0.001 at time of diagnosis of the disease (4–6 weeks while no significant differences were observed in levels at birth.Conclusion: Serum apelin was found to be of significant diagnostic value in the occurrence of ROP. Keywords: retinopathy of prematurity, preterm infants, serum apelin

  2. Mechanics of Multifault Earthquake Ruptures

    Science.gov (United States)

    Fletcher, J. M.; Oskin, M. E.; Teran, O.

    2015-12-01

    The 2010 El Mayor-Cucapah earthquake of magnitude Mw 7.2 produced the most complex rupture ever documented on the Pacific-North American plate margin, and the network of high- and low-angle faults activated in the event record systematic changes in kinematics with fault orientation. Individual faults have a broad and continuous spectrum of slip sense ranging from endmember dextral strike slip to normal slip, and even faults with thrust sense of dip slip were commonly observed in the aftershock sequence. Patterns of coseismic slip are consistent with three-dimensional constrictional strain and show that integrated transtensional shearing can be accommodated in a single earthquake. Stress inversions of coseismic surface rupture and aftershock focal mechanisms define two coaxial, but permuted stress states. The maximum (σ1) and intermediate (σ2) principal stresses are close in magnitude, but flip orientations due to topography- and density-controlled gradients in lithostatic load along the length of the rupture. Although most large earthquakes throughout the world activate slip on multiple faults, the mechanical conditions of their genesis remain poorly understood. Our work attempts to answer several key questions. 1) Why do complex fault systems exist? They must do something that simple, optimally-oriented fault systems cannot because the two types of faults are commonly located in close proximity. 2) How are faults with diverse orientations and slip senses prepared throughout the interseismic period to fail spontaneously together in a single earthquake? 3) Can a single stress state produce multi-fault failure? 4) Are variations in pore pressure, friction and cohesion required to produce simultaneous rupture? 5) How is the fabric of surface rupture affected by variations in orientation, kinematics, total geologic slip and fault zone architecture?

  3. Magnetic resonance imaging in acute tendon ruptures

    Energy Technology Data Exchange (ETDEWEB)

    Daffner, R.H.; Lupetin, A.R.; Dash, N.; Riemer, B.L.

    1986-11-01

    The diagnosis of acute tendon ruptures of the extensor mechanism of the knee or the Achilles tendon of the ankle may usually be made by clinical means. Massive soft tissue swelling accompanying these injuries often obscures the findings, however. Magnetic resonance imaging (MRI) can rapidly demonstrate these tendon ruptures. Examples of the use of MRI for quadriceps tendon, and Achilles tendon rupture are presented.

  4. Premature birth and diseases in premature infants: common genetic background?

    Science.gov (United States)

    Hallman, Mikko

    2012-04-01

    It has been proposed that during human evolution, development of obligate bipedalism, narrow birth canal cross-sectional area and the large brain have forced an adjustment in duration of pregnancy (scaling of gestational age; Plunkett 2011). Children compared to other mammals are born with proportionally small brains (compared to adult brains), suggesting shortening of pregnancy duration during recent evolution. Prevalence of both obstructed delivery and premature birth is still exceptionally high. In near term infants, functional maturity and viability is high, and gene variants predisposing to respiratory distress syndrome (RDS) are rare. Advanced antenatal and neonatal treatment practices during the new era of medicine allowed survival of also very preterm infants (gestation premature birth. Specific genes associating with diseases in preterm infants may also contribute to the susceptibility to preterm birth. Understanding and applying the knowledge of genetic interactions in normal and abnormal perinatal-neonatal development requires large, well-structured population cohorts, studies involving the whole genome and international interdisciplinary collaboration.

  5. Clinical analysis of high risk factors for premature and prognosis of premature infants%早产高危因素及早产儿预后的临床分析

    Institute of Scientific and Technical Information of China (English)

    晏金荣

    2016-01-01

    目的:分析早产高危因素及早产儿预后的影响因素。方法:回顾性分析55例早产儿的临床资料,分析早产原因及影响预后的因素。结果:导致早产的高危因素主要包括胎膜早破、前置胎盘、重度子痫前期、高龄、妊娠期贫血、多胎妊娠和瘢痕子宫等。影响早产儿预后的因素主要包括胎龄、体重、分娩方式。结论:早产的高危因素复杂。重视围生期保健、防治妊娠并发症可降低早产的发生率。%Objective:To analyze the high risk factors for premature and the influence factors for prognosis of premature infants. Methods:The clinical data of 55 cases of premature infants were analyzed retrospectively.The high risk factors for premature and the influence factors for prognosis of premature infants were analyzed.Results:The high risk factors causing premature included premature rupture of membrane,placenta previa,severe preeclampsia,age,gestational anemia,multiple pregnancy and scarred uterus.The factors affecting the prognosis of premature infants included gestational age,body weight and delivery mode.Conclusion:The high risk factors of preterm were complex.Paying attention to the perinatal health care and taking measures to prevent and control the pregnancy complications actively could reduce the incidence of premature infants.

  6. [Premature ejaculation: pills or sexology?].

    Science.gov (United States)

    Wisard, M; Audette, N

    2008-03-26

    Premature ejaculation (PE) is a frequent male sexual complaint that affects 20 to 30% of men. The exact aetiology is unknown: psychological/behavioristic and biogenic etiologies have been proposed. The introduction of selective serotonin reuptake inhibitors (SSRI) was revolutionary in the medical treatment of PE. However precautions should be taken because of potential adverse side effects. There is no clear consensus as to whether SSRI may represent an eventual cure of PE or will be required for life. The sexocorporal approach is an other treatment of PE, but convincing scientific treatment data are also lacking.

  7. Positional moulding in premature hydrocephalics.

    Directory of Open Access Journals (Sweden)

    Kumar R

    2002-04-01

    Full Text Available Seven premature hydrocephalics presenting with lambdoid positional moulding (LPM were reviewed. All were treated for hydrocephalus secondary to aqueductal stenosis, Dandy Walker Syndrome and infection. Parenchymal hemorrhage, intraventricular bleed, cortical atrophy, septal agenesis, cortical anomalies and subdural hygroma were the other common associations. These children did not show expected improvement in their higher mental functions at 6 months to 5.4 years of follow-up, following the management of hydrocephalus. It was not the LPM but associated intracranial anomalies, which were most probably responsible for their poor outcome. The differentiation from posterior plagiocephaly is also highlighted.

  8. Metabolic bone disease of prematurity

    Directory of Open Access Journals (Sweden)

    Stacy E. Rustico, MD

    2014-09-01

    Full Text Available Metabolic bone disease (MBD of prematurity remains a significant problem for preterm, chronically ill neonates. The definition and recommendations for screening and treatment of MBD vary in the literature. A recent American Academy of Pediatrics Consensus Statement may help close the gap in institutional variation, but evidence based practice guidelines remain obscure due to lack of normative data and clinical trials for preterm infants. This review highlights mineral homeostasis physiology, current recommendations in screening and monitoring, prevention and treatment strategies, and an added perspective of a bone health team serving a high volume referral neonatal intensive care center.

  9. Current therapies for premature ejaculation.

    Science.gov (United States)

    Gur, Serap; Kadowitz, Philip J; Sikka, Suresh C

    2016-07-01

    Premature ejaculation (PE) subjectively affects 20-30% of men globally. Until recently, understanding of PE was hampered by the absence of a widely accepted definition, paucity of evidence-based clinical studies, and the absence of an appropriate animal model. Here, we elaborate on the current definition of PE, its pathogenesis, currently available therapies, and future treatment prospects. Most treatments for PE are 'off-label' and include selective serotonin reuptake inhibitors (SSRIs), topical anesthetics, tramadol, and phosphodiesterase type 5 (PDE5) inhibitors. Such knowledge of the benefit and limitations of each treatment will help to direct future drug design and formulations.

  10. Premature ventricular contractions associated with isotretinoin use.

    Science.gov (United States)

    Alan, Sevil; Ünal, Betül; Yildirim, Aytül

    2016-01-01

    Isotretinoin has been considered a unique drug for acne treatment. However, it is associated with numerous adverse effects. Isotretinoin can trigger premature ventricular contractions. This report describes a 33-year-old-woman who presented with palpitations for 1 week while undergoing 1-month isotretinoin treatment for mild-moderate facial acne. An electrocardiogram and Holter monitoring showed premature ventricular contractions during isotretinoin (Roaccutane, Roche) treatment. Isotretinoin-related premature ventricular contractions were strongly suggested in this case due to the existence of documented premature ventricular contractions on electrocardiograms and the disappearance of these premature ventricular contractions two weeks after termination of the treatment To the authors' knowledge, there has been 1 reported case of premature ventricular contractions linked to isotretinoin use; this report describes a second such case.

  11. Premature ventricular contractions associated with isotretinoin use*

    Science.gov (United States)

    Alan, Sevil; Ünal, Betül; Yildirim, Aytül

    2016-01-01

    Isotretinoin has been considered a unique drug for acne treatment. However, it is associated with numerous adverse effects. Isotretinoin can trigger premature ventricular contractions. This report describes a 33-year-old-woman who presented with palpitations for 1 week while undergoing 1-month isotretinoin treatment for mild-moderate facial acne. An electrocardiogram and Holter monitoring showed premature ventricular contractions during isotretinoin (Roaccutane, Roche) treatment. Isotretinoin-related premature ventricular contractions were strongly suggested in this case due to the existence of documented premature ventricular contractions on electrocardiograms and the disappearance of these premature ventricular contractions two weeks after termination of the treatment To the authors' knowledge, there has been 1 reported case of premature ventricular contractions linked to isotretinoin use; this report describes a second such case. PMID:28099609

  12. Ultrasonography in traumatic rupture of Schilles tendon

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Kil Ho; Byun, Woo Mok; Lee, Dong Chul; Kim, Se Dong; Park, Bok Hwan [Yeungnam University College of Medicine, Gyeongsan (Korea, Republic of)

    1993-12-15

    Ultrasonography was performed prospectively in 16 patients with suspected rupture of Achilles tendon from March to October 1992 to evaluate the diagnostic value of ultrasonography. Ultrasonography examinations were done according to standard techniques, and then dynamic evaluations were performed during passive plantar flexion of the ankle. We reviewed 10 confirmed cases of ruptured tendons, among which 9 cases were confirmed by operation,and one by ultrasonography and MRI. ultrasonic results were compared with the findings at physical examination and surgery. The normal thickness of the Achilles tendons in healthy sides on ultrasonography ranged from 3 to 5mm.The ruptured tendons were 6-10mm thick at 1-2cm superior to the upper margin of Os Calcis. Rupture sites on ultrasonography were exactly predicted in 7 among the 9 operative cases. In on non-operative case, the rupture site on ultrasonography corresponded to that seen on MRI. Tendon bucking on dynamic ultrasonography was positive in all 4 complete ruptures. In 2 of the 6 partial ruptures which were near complete tears, tendon buckling was also observed. In conclusion, ultrasonography is a valuable diagnostic modality in the diagnosis of Achilles tendon rupture, the differentiation between total and partial rupture, and in determining the rupture site. We consider ultrasonography of tendon as an important diagnostic toot that may guide the treatment plan in the traumatic rupture of the Achilles tendon

  13. The diagnosis of breast implant rupture

    DEFF Research Database (Denmark)

    Hölmich, Lisbet R; Vejborg, Ilse; Conrad, Carsten;

    2005-01-01

    STUDY OBJECTIVE: The aim of this study was to evaluate the accuracy of Magnetic Resonance Imaging (MRI) as performed according to a strict study protocol in diagnosing rupture of silicone breast implants. MATERIAL AND METHODS: The study population consisted of 64 women with 118 implants, who had...... participated in either one or two study MRI examinations, aiming at determining the prevalence and incidence of silent implant rupture, respectively, and who subsequently underwent explantation. Implant rupture status was determined by four independent readers and a consensus diagnosis of either rupture...... (intracapsular or extracapsular), possible rupture or intact implant was then obtained. Strict predetermined rupture criteria were applied as described in this report and findings at surgery were abstracted in a standardised manner and results compared. RESULTS: At MRI, 66 implants were diagnosed as ruptured...

  14. Premature temporal theta (PT theta).

    Science.gov (United States)

    Hughes, J R; Fino, J J; Hart, L A

    1987-07-01

    A distinctive pattern called premature temporal theta (PT theta) was studied in 436 infants, ranging in age from 24 to 46 weeks. The pattern is seen in early prematurity, maximizes at 29-31 weeks and then diminishes and disappears near term. Usually the pattern is found independently on both temporal areas, but with a right-sided preference. Patients without PT theta or with a significantly low amount had either neurological or non-neurological (medical) conditions. With age there is a tendency for an increase in frequency and a decrease in amplitude. Five different peaks in the amount of this pattern are seen at approximately every month. Unilateral PT theta tends to be seen in older babies, more often on the right side and with an abnormal EEG. An abnormal EEG is usually associated with a delay in both the appearance and disappearance of this wave form. PT theta is also associated mainly with REM or active sleep. A polynomial rather than an exponential or power function best describes these data with changes of age. PT theta may arise from the inferior temporal gyrus and/or especially the transverse gyrus.

  15. [Quadriceps and patellar tendon ruptures].

    Science.gov (United States)

    Grim, C; Lorbach, O; Engelhardt, M

    2010-12-01

    Ruptures of the quadriceps or patellar tendon are uncommon but extremely relevant injuries. Early diagnosis and surgical treatment with a stable suture construction are mandatory for a good postoperative clinical outcome. The standard methods of repair for quadriceps and patellar tendon injuries include the placement of suture loops through transpatellar tunnels. Reinforcement with either a wire cerclage or a PDS cord is used in patellar tendon repair. The PDS cord can also be applied as augmentation in quadriceps tendon repair. In secondary patellar tendon repair an autologous semitendinosus graft can be used. For chronic quadriceps tendon defects a V-shaped tendon flap with a distal footing is recommended. The different methods of repair should lead to early functional postoperative treatment. The clinical outcome after surgical treatment of patellar and quadriceps tendon ruptures is mainly good.

  16. Bubble rupture in bubble electrospinning

    Directory of Open Access Journals (Sweden)

    Chen Rouxi

    2015-01-01

    Full Text Available As the distinctive properties and different applications of nanofibers, the demand of nanofibers increased sharply in recently years. Bubble electrospinning is one of the most effective and industrialized methods for nanofiber production. To optimize the set-up of bubble electrospinning and improve its mass production, the dynamic properties of un-charged and charged bubbles are studied experimentally, the growth and rupture process of a bubble are also discussed in this paper.

  17. Molecular dynamics of interface rupture

    Science.gov (United States)

    Koplik, Joel; Banavar, Jayanth R.

    1993-01-01

    Several situations have been studied in which a fluid-vapor or fluid-fluid interface ruptures, using molecular dynamics simulations of 3000 to 20,000 Lennard-Jones molecules in three dimensions. The cases studied are the Rayleigh instability of a liquid thread, the burst of a liquid drop immersed in a second liquid undergoing shear, and the rupture of a liquid sheet in an extensional flow. The late stages of the rupture process involve the gradual withdrawal of molecules from a thinning neck, or the appearance and growth of holes in a sheet. In all cases, it is found that despite the small size of the systems studied, tens of angstroms, the dynamics is in at least qualitative accord with the behavior expected from continuum calculations, and in some cases the agreement is to within tens of percent. Remarkably, this agreement occurs even though the Eulerian velocity and stress fields are essentially unmeasurable - dominated by thermal noise. The limitations and prospects for such molecular simulation techniques are assessed.

  18. Quadriceps tendon rupture - treatment results

    Directory of Open Access Journals (Sweden)

    Popov Iva

    2013-01-01

    Full Text Available Introduction. Quadriceps tendon rupture is a rare but rather serious injury. If this injury is not promptly recognized and early operated, it may lead to disability. This research was aimed at pointing out the results and complications of the quadriceps tendon rupture surgical treatment. Material and Methods. This retrospective multicentric study was conducted in a group of 29 patients (mostly elderly men. Lysholm knee scoring scale was used to evaluate the surgical results. The post-operative results were compared in relation to the type of tendon rupture reconstructions (acute or chronic, various surgical techniques, type of injuries (unilateral or bilateral as well as the presence or absence of comorbid risk factors in the patients. Results. The average value of a Lysholm score was 87.6. Excellent and satisfactory Lysholm score results dominated in our sample of patients. Better post-operative results were recorded in the group of patients without risk factors, in case of a bilateral injury, and in case of an acute injury. The best result was obtained after performing the reconstruction using anchors, and the worst result came after using Codivilla technique. Discussion and Conclusion. Early diagnosis and surgical treatment are an absolute imperative in management of this injury. We have not proven that a certain surgical technique has an advantage over the others. A comorbid risk factor is related to a lower Lysholm score. Despite a few cases of complications, we can conclude that the surgical treatment yields satisfactory results.

  19. Splenic rupture following routine colonoscopy.

    Science.gov (United States)

    Rasul, Tabraze; Leung, Edmund; McArdle, Kirsten; Pathak, Rajiv; Dalmia, Sanjay

    2010-10-01

    Splenic rupture is a life-threatening condition characterized by internal hemorrhage, often difficult to diagnose. Colonoscopy is a gold standard routine diagnostic test to investigate patients with gastrointestinal symptoms as well as to those on the screening program for colorectal cancer. Splenic injury is seldomly discussed during consent for colonoscopy, as opposed to colonic perforation, as its prevalence accounts for less than 0.1%. A 66-year-old Caucasian woman with no history of collagen disorder was electively admitted for routine colonoscopy for surveillance of adenoma. She was admitted following the procedure for re-dosing of warfarin, which was stopped prior to the colonoscopy. The patient was found collapsed on the ward the following day with clinical shock and anemia. Computed tomography demonstrated grade 4 splenic rupture. Immediate blood transfusion and splenectomy was required. Splenic rupture following routine colonoscopy is extremely rare. Awareness of it on this occasion saved the patient's life. Despite it being a rare association, the seriousness warrants inclusion in all information leaflets concerning colonoscopy and during its consent.

  20. Molecular dynamics of interface rupture

    Science.gov (United States)

    Koplik, Joel; Banavar, Jayanth R.

    1993-01-01

    Several situations have been studied in which a fluid-vapor or fluid-fluid interface ruptures, using molecular dynamics simulations of 3000 to 20,000 Lennard-Jones molecules in three dimensions. The cases studied are the Rayleigh instability of a liquid thread, the burst of a liquid drop immersed in a second liquid undergoing shear, and the rupture of a liquid sheet in an extensional flow. The late stages of the rupture process involve the gradual withdrawal of molecules from a thinning neck, or the appearance and growth of holes in a sheet. In all cases, it is found that despite the small size of the systems studied, tens of angstroms, the dynamics is in at least qualitative accord with the behavior expected from continuum calculations, and in some cases the agreement is to within tens of percent. Remarkably, this agreement occurs even though the Eulerian velocity and stress fields are essentially unmeasurable - dominated by thermal noise. The limitations and prospects for such molecular simulation techniques are assessed.

  1. Vaginal Fluid hCG Levels for Detecting Premature Rupture of Membranes

    Directory of Open Access Journals (Sweden)

    T. Artimani

    2004-04-01

    Full Text Available The aim of this study was to determine whether there is any different in hCG levels of vaginal fluids from normal pregnant women, women with confirmed PROM and with suspected PROM. After irrigating the posterior vaginal fornix with 3 ml of sterile saline and procuring vaginal washing , we measured hCG levels. Samples were analyzed from 38 normal pregnant women , 31 women with confirmed PROM , 28 women with suspected PROM. The mean of vaginal fluid hCG levels of normal pregnant women were 11.2 (0.00-98.6 mIu/ml. That of women with PROM was 140.2 (0.5 , 390.1 and that of women with suspected PROM was 21.5 (0.0 , 143.9. Sensivity was 80%, specility 83% , positive predictive value 73.7% , negative predictive value 88.1% , using a cut-value 20. It was concluded that the hCG level in vaginal fluid is a marker of PROM during third trimester.

  2. Pathogenesis of preterm labor and preterm premature rupture of membranes associated with intraamniotic infection.

    Science.gov (United States)

    Gomez, R; Romero, R; Edwin, S S; David, C

    1997-03-01

    We have proposed a model in which the initiation of human parturition in the presence of infection is controlled by the host. Systemic maternal infections such as pyelonephritis or localized infections such as deciduitis can trigger parturition by the activation of the monocyte and macrophage system in peripheral blood and human decidua. Preterm labor and preterm PROM can, according to this, be considered events that occur when the intrauterine or maternal environment is hostile and threaten the survival of the fetal-maternal pair. From this point of view, the initiation of preterm labor may have survival value. Why does intrauterine infection result in preterm labor in some cases and PROM in others? It is possible that regulation of different components of the host response has an important role to play in determining clinical presentation. Thus, if preferential activation of the host response leads to the secretion of uterotonic agents (i.e., prostaglandins), preterm labor will result. On the other hand, if the activation of the host response results predominantly in the production of proteases (i.e., leukocyte elastase and MMPs), patients are more likely to experience PROM. Preterm labor and preterm PROM can be considered expressions of the same basic phenomenon: activation of the host-defense macrophage system. Although we have provided evidence that infection is an important factor in the pathogenesis of these conditions, preterm parturition should be considered as a syndrome with multiple causes.

  3. 7 CFR 29.2290 - Premature primings.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Premature primings. 29.2290 Section 29.2290 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards... 21) § 29.2290 Premature primings. Ground leaves harvested before reaching complete growth and...

  4. 28 CFR 51.22 - Premature submissions.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Premature submissions. 51.22 Section 51.22 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PROCEDURES FOR THE ADMINISTRATION OF... § 51.22 Premature submissions. The Attorney General will not consider on the merits: (a) Any proposal...

  5. Premature infants' health at multiple induced pregnancy.

    Directory of Open Access Journals (Sweden)

    Chernenkov Yu.V.

    2015-09-01

    Full Text Available Objective: to define the risk factors adversely influencing prenatal development at premature birth at use of methods of assisted reproductive technology (ART; to estimate premature' infants health from multiple induced pregnancy according to Perinatal Center of Saratov for last 3 years. Material and Methods. Under supervision there were 139 pregnant women with application ART. 202 children (51 twins were born and 5 triplet babies, from them 83 premature infants born from multiple induced pregnancy have been analyzed. Results. The newborns examined by method ART, were distributed as follows: 22-28 weeks — 19 children; 29-32 weeks — 23; 33-36 weeks — 41. Asphyxia at birth was marked at all premature infants. Respiratory insufficiency at birth is revealed in 87,3% of cases. The most frequent pathologies in premature infants are revealed: neurologic infringements and bronchopulmonary pathology occured at all children, developmental anomaly — 33, 8%, retinopathies in premature infants — 26,5%. The mortality causes include: extreme immaturity, cerebral leukomalacia, IVN 3 degrees. Conclusion. The risk factors, premature birth at application of methods ART are revealed: aged primiparas, pharmacological influence, absence of physiological conditions of prenatal development; multifetation. The high percent of birth of children with ELBW and ULBW is revealed. RDCN with further BPD development, retinopathies in premature infants and CNS defeat is more often occured.

  6. Human milk for the premature infant

    Science.gov (United States)

    Underwood, Mark A.

    2012-01-01

    Synopsis Premature infants are a heterogeneous group with widely differing needs for nutrition and immune protection with risk of growth failure, developmental delays, necrotizing enterocolitis, and late-onset sepsis increasing with decreasing gestational age and birth weight. Human milk from women delivering prematurely has more protein and higher levels of many bioactive molecules compared to milk from women delivering at term. Human milk must be fortified for small premature infants to achieve adequate growth. Mother’s own milk improves growth and neurodevelopment and decreases the risk of necrotizing enterocolitis and late-onset sepsis and should therefore be the primary enteral diet of premature infants. Donor milk is a valuable resource for premature infants whose mothers are unable to provide an adequate supply of milk, but presents significant challenges including the need for pasteurization, nutritional and biochemical deficiencies and a limited supply. PMID:23178065

  7. Histologic analysis of ruptured quadriceps tendons.

    Science.gov (United States)

    Trobisch, Per David; Bauman, Matthias; Weise, Kuno; Stuby, Fabian; Hak, David J

    2010-01-01

    Quadriceps tendon ruptures are uncommon injuries. Degenerative changes in the tendon are felt to be an important precondition for rupture. We retrospectively reviewed 45 quadriceps tendon ruptures in 42 patients. Quadriceps tendon ruptures occurred most often in the sixth and seventh decade of life. Men were affected six times as often as women. A tissue sample from the rupture-zone was obtained in 22 cases and histologic analysis was performed. Degenerative changes were present in only 14 (64%) of the 22 samples. We observed an increasing ratio of degenerative to nondegenerative tendons with increasing patient age. Our data suggests that quadriceps tendon rupture, especially in younger patients, can occur in the absence of pathologic tendon degeneration.

  8. Treatment of bronchial ruptures by delayed surgery

    Institute of Scientific and Technical Information of China (English)

    1999-01-01

    Objective:To study the causes that resulted in delayed surgery for bronchial ruptures and the results.Methods:The cases with the bronchial ruptures by the delayed surgery last decade were retrospectively reviewed.The causes and unsatisfactory results were analysed.Results:The severe complications usually occurred after the delayed surgery and the results were not as satisfactory as those by early surgery.Conclusion:The bronchial ruptures ought to be operated in the early stage after being wounded.

  9. Achilles tendon rupture; assessment of nonoperative treatment

    DEFF Research Database (Denmark)

    Barfod, Kristoffer Weisskirchner

    2014-01-01

    BACKGROUND: Acute Achilles tendon rupture is a frequent and potentially disabling injury. Over the past decade a change in treatment of acute Achilles tendon rupture away from operative towards non-operative treatment has taken place. However, the optimal non-operative treatment protocol remains...... and Sweden. Immediate weight-bearing was found to be safe and recommendable in non-operative treatment of acute Achilles tendon rupture. The novel ultrasound measurement showed excellent reliability and acceptable validity and agreement....

  10. Achilles tendon rupture; assessment of nonoperative treatment

    DEFF Research Database (Denmark)

    Barfod, Kristoffer Weisskirchner; Troelsen, Anders

    2014-01-01

    BACKGROUND: Acute Achilles tendon rupture is a frequent and potentially disabling injury. Over the past decade a change in treatment ofacute Achilles tendon rupture away from operative towards non-operative treatment has taken place. However, the optimal non-operative treatment protocol remains...... and Sweden. Immediate weight-bearing was found to be safe and recommendable in non-operative treatment of acute Achilles tendon rupture. The novel ultrasound measurement showed excellent reliability and acceptable validity and agreement....

  11. Pathological rupture of malarial spleen.

    Directory of Open Access Journals (Sweden)

    Mokashi A

    1992-07-01

    Full Text Available Two cases of spontaneous rupture of malarial spleen are reported here. One of them was a male who was on chloroquine for an acute attack of malaria. While on therapy, he complained of pain in left hypochondrium followed by palpitations. The other patient was a female who was admitted for continuous dull aching pain and fever. In both the patients, exploratory laparotomy revealed an enlarged spleen with tear. Splenectomy was performed. Histopathological examination revealed dilated congested sinusoid with follicular atrophy, and RBCs with malarial parasites. The post-operative course was smooth in both patients.

  12. Ruptured jejunum following Heimlich maneuver.

    Science.gov (United States)

    Razaboni, R M; Brathwaite, C E; Dwyer, W A

    1986-01-01

    The Heimlich maneuver, over time, has proved to be a useful resuscitative procedure in the management of cases with airway occlusion secondary to foreign body. Medical treatments, however, can have side effects, and this maneuver is no exception. A previously unreported complication is presented, that of jejunal rupture. The proper application of the maneuver minimizes the number of side effects; however, since they do occur, it is suggested that all persons subject to this maneuver be subsequently evaluated by a physician as soon after the incident as is practicable.

  13. The rupture in visual language:

    OpenAIRE

    Kula, Ömür; Kula, Omur

    2006-01-01

    The shift of arts from conventional forms of canvas-painting and sculpture to collage, ready-mades, installations and performances as it had occurred in the history of western art follow a linear and natural unfolding in parallel with sociopolitical evolvements. In the case of Turkish visual arts, this kind of a transformation projects to the time period between 1960s to 1990s where the face of arts change not smoothly but rather in the form of a 'rupture' as new tendencies are embraced, prac...

  14. Ruptured pediatric posterior cerebral artery aneurysm 9 years after the onset of Kawasaki disease: a case report.

    Science.gov (United States)

    Tanaka, Satoshi; Sagiuchi, Takao; Kobayashi, Ikuo

    2007-06-01

    A 12-year-old boy who had a history of Kawasaki disease 9 years ago experienced a subarachnoid hemorrhage by ruptured right posterior cerebral artery aneurysm. On day 1 operation, as the aneurysm was very fragile and bled easily, two intraoperative ruptures, including a very premature rupture, were encountered. As a result, a left hemiparesis especially severe in the left hand was caused by the right anterior thalamic infarction due to the occlusion of a thalamo-perforating artery arising near the neck of the aneurysm. The histopathological examination of the intraoperative excised aneurysmal dome disclosed the thickening of the endothelial inner due to the endothelial hypertrophy and the invasion of inflammatory cells. This finding of the aneurysm was partially mimicking the finding of the coronary artery of the patients with Kawasaki disease. The combination of cerebral aneurysm and Kawasaki disease has never been reported until now, and the etiology of the aneurysm of this patient is unclear.

  15. Mechanical model of vulnerable atherosclerotic plaque rupture

    Institute of Scientific and Technical Information of China (English)

    SU; Haijun; ZHANG; Mei; ZHANG; Yun

    2004-01-01

    Rupture of atherosclerotic plaque is the main trigger of acute cardiovascular events, but the mechanism of plaque rupture is still unknown. We have constructed a model describing the motion of the fibrous cap of the plaque using the theory of elastic mechanics and studied the stability of the plaque theoretically. It has shown that plaque rupture is the result of a dynamic interplay between factors intrinsic to the plaque itself and extrinsic factors. We have proposed a new mechanism of plaque rupture, given a new explanation about the nonlinear dynamic progress of atherosclerosis and suggested a method to identify the vulnerable plaques to manage atherosclerosis.

  16. Delayed presentation of traumatic intraperitoneal bladder rupture

    Energy Technology Data Exchange (ETDEWEB)

    Brown, D.; Magill, H.L.; Black, T.L.

    1986-03-01

    A child with urine ascites as a delayed manifestation of post-traumatic intraperitoneal bladder rupture is presented. The diagnosis was suggested by abdominal CT scan and confirmed with a cystogram. While uncommon, late presentation of intraperitoneal bladder rupture following trauma may occur from masking of a primary laceration or development of secondary rupture at the site of a hematoma in the bladder wall. Since CT may be a primary diagnostic study performed following abdominal trauma, the radiologist should be aware of CT findings suggesting bladder rupture and of the possibility of delayed presentation of this injury.

  17. Stress rupture properties of GH4169 superalloy

    Directory of Open Access Journals (Sweden)

    Xudong Lu

    2014-04-01

    Full Text Available GH4169 alloy is a nickel-based superalloy extensively used in the aircraft engine industry because of its excellent mechanical properties and good fabrication ability. The mechanical properties of the GH4169 at high temperature, rupture stress under severe condition deserves a close attention. In this paper, the creep rupture of the GH4169 alloy under constant load and different temperatures from 550 °C to 700 °C conditions is systematically evaluated and major impact factors in the stress rupture behavior are analyzed. Furthermore, an improving method for the alloy stress rupture is proposed.

  18. Premature Ventricular Complexes and Premature Ventricular Complex Induced Cardiomyopathy.

    Science.gov (United States)

    Latchamsetty, Rakesh; Bogun, Frank

    2015-09-01

    Presentation, prognosis, and management of premature ventricular complexes (PVCs) vary significantly among patients and depend on PVC characteristics as well as patient comorbidities. Presentation can range from incidental discovery in an asymptomatic patient to debilitating heart failure. Prognosis depends on, among other factors, the presence or absence of structural heart disease, PVC burden and other factors detailed in this review. Our understanding of the clinical significance of frequent PVCs, particularly as it relates to development of cardiomyopathy, has advanced greatly in the past decade. In this article, we explore the mechanisms governing PVC initiation and discuss prevalence and frequency of PVCs in the general population. We also explore prognostic implications based on PVC frequency as well as the presence or absence of underlying heart disease. We then take a focused look at PVC-induced cardiomyopathy and identify predictors for developing cardiomyopathy. Finally, we discuss clinical evaluation and management of patients presenting with frequent PVCs. Management can include clinical observation, addressing reversible causes, lifestyle modification, pharmacotherapy, or catheter ablation.

  19. Psychosocial interventions for premature ejaculation

    Directory of Open Access Journals (Sweden)

    Tamara Melnik

    Full Text Available BACKGROUND: Premature ejaculation (PE is a very common sexual dysfunction among patients, and with varying prevalence estimates ranging from 3% to 20%. Although psychological issues are present in most patients with premature PE, as a cause or as a consequence, research on the effects of psychological approaches for PE has in general not been controlled or randomised and is lacking in long-term follow up. OBJECTIVE: To assess the efficacy of psychosocial interventions for PE. CRITERIA FOR CONSIDERING STUDIES FOR THIS REVIEW: Trials were searched in computerized general and specialized databases, such as: MEDLINE by PubMed (1966 to 2010; PsycINFO (1974 to 2010; EMBASE (1980 to 2010; LILACS (1982 to 2010; the Cochrane Central Register of Controlled Trials (Cochrane Library, 2010; and by checking bibliographies, and contacting manufacturers and researchers. SELECTION CRITERIA: Randomised or quasi-randomised controlled trials evaluating psychosocial interventions compared with different psychosocial interventions, pharmacological interventions, waiting list, or no treatment for PE. DATA COLLECTION AND ANALYSIS: Information on patients, interventions, and outcomes was extracted by at least two independent reviewers using a standard form. The primary outcome measure for comparing the effects of psychosocial interventions to waiting list and standard medications was improvement in IELT (i.e., time from vaginal penetration to ejaculation. The secondary outcome was change in validated PE questionnaires. MAIN RESULTS: In one study behavioral therapy (BT was significantly better than waiting list for duration of intercourse (MD (mean difference 407.90 seconds, 95% CI 302.42 to 513.38, and couples' sexual satisfaction (MD -26.10, CI -50.48 to -1.72. BT was also significantly better for a new functional-sexological treatment (FS (MD 412.00 seconds, 95% CI 305.88 to 518.12, change over time in subjective perception of duration of intercourse (Women: MD 2

  20. Quadriceps and patellar tendon ruptures.

    Science.gov (United States)

    Lee, Dennis; Stinner, Daniel; Mir, Hassan

    2013-10-01

    The diagnosis of quadriceps and patellar tendon ruptures requires a high index of suspicion and thorough history-taking to assess for medical comorbidities that may predispose patients to tendon degeneration. Radiographic assessment with plain films supplemented by ultrasound and magnetic resonance imaging when the work-up is equivocal further aids diagnosis; however, advanced imaging is often unnecessary in patients with functional extensor mechanism deficits. Acute repair is preferred, and transpatellar bone tunnels serve as the primary form of fixation when the tendon rupture occurs at the patellar insertion, with or without augmentation depending on surgeon preference. Chronic tears and disruptions following total knee arthroplasty are special cases requiring reconstructions with allograft, synthetic mesh, or autograft. Rehabilitation protocols generally allow immediate weight-bearing with the knee locked in extension and crutch support. Limited arc motion is started early with active flexion and passive extension and then advanced progressively, followed by full active range of motion and strengthening. Complications are few but include quadriceps atrophy, knee stiffness, and rerupture. Outcomes are excellent if repair is done acutely, with poorer outcomes associated with delayed repair.

  1. HELLP Syndrome Complicated with Postpartum Subcapsular Ruptured Liver Hematoma and Purtscher-Like Retinopathy

    Directory of Open Access Journals (Sweden)

    Daniela Cernea

    2012-01-01

    Full Text Available Purtscher's retinopathy is usually associated with trauma, acute pancreatitis, vasculitis, lupus, and bone fractures. It was rarely described postpartum in patients with preeclampsia as well as associated with HELLP syndrome. We present a case of a multiparous patient aged 44 with severe preeclampsia and postpartum HELLP syndrome complicated with Purtscher-like retinopathy and large ruptured subcapsular liver hematoma that required emergency abdominal surgery after premature delivery of a dead fetus. Postsurgical outcome was favorable regarding both liver function and visual acuity.

  2. Acute appendicitis in a premature baby

    Energy Technology Data Exchange (ETDEWEB)

    Beluffi, Giampiero; Alberici, Elisa [Department of Radiodiagnosis, Section of Paediatric Radiology, IRCCS Policlinico S. Matteo, Piazzale Golgi 2, 27100 Pavia PV (Italy)

    2002-07-01

    A case of acute appendicitis in a premature baby in whom diagnosis was suggested on plain films of the abdomen is presented. In this baby air in a hollow viscus suspected of being an enlarged appendix was the clue to diagnosis. The diagnostic dilemma of this rare and life-threatening condition in premature babies and newborns is underlined. The relevance of different imaging modalities and of different findings in this age group is discussed. Awareness of this rare condition and possible differential diagnosis in newborns and premature babies is stressed. (orig.)

  3. [Premature newborn: a case presentation].

    Science.gov (United States)

    Pastor Rodríguez, Jesús David; Pastor Bravo, María Del Mar; López García, Visitación; Cotes Teruel, María Isabel; Mellado, Jesús Eulogio; Cárceles, José Jara

    2010-01-01

    A case is presented of a premature newborn of 27 weeks gestation and weighing 420 grams who was delivered as a result of a maternal pre-eclampsia and retarded intra-uterine growth. During the 125 days of hospitalisation, an individual care plan based on the Virginia Henderson model was devised and applied to both the child and her parents using NANDA diagnostics, interventions according to the NIC classification, and the expected results according to the NOC classification. The Marjory Gordon functional patterns were used for the initial assessment. By applying the pre-term newborn (PTNB) plan, all their needs were provided and were modified throughout the hospital stay, with new needs that were added to the established ones. These required a continuous assessment with the subsequent adapting of the care plan. Likewise, the care required by the parents varied from the initial grief due to the possible loss of their child to learning the alarm signs and the home care that their child would need. The child was finally discharged weighing 2900 grams and with normal neurological and psychomotor development, although with a lower weight appropriate to her age. Currently, at 2 years old, the child has a normal neurological and psychomotor development, but with weight and size lower than the P(3) percentile. She requires speech therapy treatment due to paralysis of the right vocal cord.

  4. Psychosexual therapy for premature ejaculation.

    Science.gov (United States)

    Althof, Stanley E

    2016-08-01

    Premature ejaculation (PE) is a male sexual dysfunction that creates considerable anguish for the man, his partner and their relationship. PE is not one disorder but includes the four subtypes (lifelong, acquired, natural and subjective) each with unique psychological concerns and issues. Psychological treatment for men and couples with PE addresses sexual skills/techniques but also focuses on issues of self-esteem, performance anxiety and interpersonal conflict. The outcome studies for psychotherapy alone are difficult to interpret and compare because of poor methodological design (lack of control groups, small sample size, poor outcome measures and lack of follow-up). However, the few studies that surmount these methodological hurdles suggest that psychological intervention offers men and couples a promising treatment option. Combination pharmaco- and psychotherapy is the most promising intervention for lifelong and acquired PE and offers superior efficacy to drug alone. This is because men and couples learn sexual skills, address the intrapsychic, interpersonal and cognitive issues that precipitate and maintain the dysfunction.

  5. The epidemiology of premature ejaculation.

    Science.gov (United States)

    Saitz, Theodore Robert; Serefoglu, Ege Can

    2016-08-01

    Vast advances have occurred over the past decade with regards to understanding the epidemiology, pathophysiology and management of premature ejaculation (PE); however, we still have much to learn about this common sexual problem. As a standardized evidence-based definition of PE has only recently been established, the reported prevalence rates of PE prior to this definition have been difficult to interpret. As a result, a large range of conflicting prevalence rates have been reported. In addition to the lack of a standardized definition and operational criteria, the method of recruitment for study participation and method of data collection have obviously contributed to the broad range of reported prevalence rates. The new criteria and classification of PE will allow for continued research into the diverse phenomenology, etiology and pathogenesis of the disease to be conducted. While the absolute pathophysiology and true prevalence of PE remains unclear, developing a better understanding of the true prevalence of the disease will allow for the completion of more accurate analysis and treatment of the disease.

  6. [Sexological intervention on premature ejaculation].

    Science.gov (United States)

    San Martín Blanco, C

    2014-07-01

    Strategies, recommendations and techniques proposed by sex therapy for intervention on premature ejaculation, have represented for nearly four decades the most effective model of intervention in this sexual dysfunction, which currently is complemented by the efficacy of dapoxetine drug treatment. Clinical experience and recent studies support that combined intervention offers the best therapeutic results. In addition in sex therapy, etiologic diagnosis is obtained from the analysis of the interrelationship of the couple. Diagnostic and therapeutic intervention has to be always centered in the relationship, so the techniques and resources must be applied with the expectation of being implemented in the sexual interaction. It will therefore be the relationship that receive treatment, even if medication is used for one of the members of the couple. On the other hand, this model of intervention can be implemented by a professional with training, although not necessarily a specialist. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Medicina Rural y Generalista (SEMERGEN). All rights reserved.

  7. Medical therapy for premature ejaculation

    Science.gov (United States)

    Mohee, Amar; Eardley, Ian

    2011-01-01

    Premature ejaculation (PE) is a common male sexual dysfunction. Advances in PE research have been hampered owing to a nonstandardized definition of PE, until the definition by the International Society of Sexual Medicine (ISSM) in 2009. Once the diagnosis of PE is established through a thorough history, a variety of medical therapies is available, including tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs), centrally acting opiates, phosphodiesterase 5 inhibitors and topical desensitizing creams. Most of these treatments increase the intravaginal ejaculation latency time (IELT) and patient satisfaction scores, with the most convincing evidence for SSRIs and topical creams. Daily SSRIs such as paroxetine, although efficacious, do have a substantial and prolonged side effect profile. Dapoxetine, which is a on-demand SSRI, is the only licensed drug for the treatment of PE, increasing IELT by a factor of 2.5 to 3 with limited and tolerable side effects. In the near future, the topical aerosol PSD502 is due to be licensed for the treatment of PE, increasing IELT by up to a factor of 6 but having minimal local and negligible systemic side effects. PMID:22046199

  8. Tracheal rupture post-emergency intubation

    OpenAIRE

    Andrea Billè; Luca Errico; Francesco Ardissone; Luciano Cardinale

    2009-01-01

    Tracheal rupture is an uncommon and potentially lifethreatening complication of endotracheal intubation. We present a case of intrathoracic tracheal rupture in a female patient who required emergent endotracheal intubation for acute respiratory distress related to chronic obstructive pulmonary disease exacerbation. Possible contributing factors to tracheal injury included overinflation of the tube cuff, chronic obstructive pulmonary disease, and chronic steroid use. The patient underwent surg...

  9. Spontaneous rupture of choledochal cyst: case report

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Ho Seob; Nam, Kyung Jin; Lee, Jin Hwa; Kim, Chan Sung; Choi, Jong Cheol; Oh, Jong Young [Dong-a University College of Medicine, Pusan (Korea, Republic of)

    2002-11-01

    Spontaneous rupture of a choledochal cyst leading to biliary peritonitis is a rare complication which can be fatal if not promptly diagnosed. The authors report the ultrasound and CT findings of two cases of spontaneous choledochal cystic rupture and the biliary peritonitis which ensued.

  10. Ruptured liver abscess in a neonate

    Directory of Open Access Journals (Sweden)

    Prashant Jain

    2012-01-01

    Full Text Available We report a rare case of 17-day-old neonate, diagnosed to have ruptured liver abscess secondary to Methicillin-resistant Staphylococcal aureus infection. The child presented with septicemia and abdominal distension. On exploration, there was pyoperitoneum with ruptured liver abscess.

  11. Simultaneous and spontaneous bilateral quadriceps tendons rupture.

    Science.gov (United States)

    Celik, Evrim Coşkun; Ozbaydar, Mehmet; Ofluoglu, Demet; Demircay, Emre

    2012-07-01

    Simultaneous and spontaneous bilateral quadriceps tendon rupture is an uncommon injury that is usually seen in association with multiple medical conditions and some medications. We report a case of simultaneous and spontaneous bilateral quadriceps tendon rupture that may be related to the long-term use of a statin.

  12. Migraine before rupture of intracranial aneurysms

    DEFF Research Database (Denmark)

    Lebedeva, Elena R; Gurary, Natalia M; Sakovich, Vladimir P

    2013-01-01

    Rupture of a saccular intracranial aneurysm (SIA) causes thunderclap headache but it remains unclear whether headache in general and migraine in particular are more prevalent in patients with unruptured SIA.......Rupture of a saccular intracranial aneurysm (SIA) causes thunderclap headache but it remains unclear whether headache in general and migraine in particular are more prevalent in patients with unruptured SIA....

  13. Simultaneous bilateral patellar tendon rupture without

    Directory of Open Access Journals (Sweden)

    LU Hua-ding

    2012-04-01

    Full Text Available 【Abstract】There is a dearth of case reports de-scribing simultaneous bilateral patellar tendon ruptures in the medical literature. These ruptures are often associated with systemic disorders such as lupus erythematosus or chronic steroid use. The author describes a case of a 24-year-old man who sustained traumatic bilateral patellar ten-don ruptures without any history of systemic disease or steroidal medication. We repaired and reattached the rup-tured tendons to the patella and augmented our procedure with allogeneic tendon followed by wire loop reinforcement. One year after operation, the patient regained a satisfactory range of motion of both knees with good quadriceps strength and no extensor lag. The recurrent microtrauma from a history of intense sports activity and a high body mass index may have played an important role in this trauma event. Key words: Patella; Patellar ligament; Rupture; Ten-don injuries; Knee

  14. Should the ruptured renal allograft be removed?

    Science.gov (United States)

    Dryburgh, P; Porter, K A; Krom, R A; Uchida, K; West, J C; Weil, R; Starzl, T E

    1979-07-01

    During a 16-month period when 93 renal transplants were performed, eight kidney graft ruptures were detected within 18 days of transplantation, without evidence of venous obstruction. Six grafts were removed at the time of an exploratory operation for rupture and only one showed signs of probable irreversible rejection when examined by microscopy. Two graft ruptures were repaired and one of these grafts has had good long-term function 22 months later. These observations suggest that if bleeding at the site of grafts has had good long-term function 22 months later. These observations suggest that if bleeding at the site of graft rupture can be securely controlled and if the conditions of the patient and of the graft are favorable except for the rupture, it may be possible to save more than one of eight grafts.

  15. The influence of seasonality and weather changes on premature birth incidence.

    Science.gov (United States)

    Muresan, Daniel; Staicu, Adelina; Zaharie, Gabriela; Marginean, Claudiu; Rotar, Ioana Cristina

    2017-01-01

    Although the effects of meteorological factors on the general population health are widely documented, little is known about their influence on human pregnancy and birth. The present study aims at analyzing the influence of the atmospheric conditions on premature births. One hundred and eight nine cases of premature births were included in the study, with a gestational age between 24 to 37 weeks of amenorrhea. Cases with antepartum fetal death and those with uncertain gestational age have been excluded. Daily weather data were obtained using http://www.wunderground.com site. A Pearson's product-moment correlation was run to assess the relationship between weekly preterm birth incidence and the total number of premature births and the mean maximum and minimum temperature (Tmax, Tmin), maximum and minimum average humidity (Umax, Umin), maximum and minimum atmospheric pressure mean (P max, P min), average wind speed and average quantity precipitations, calculated for one calendar week. Approximately 7.7% of all births during the study period occurred before 37 weeks of gestation, the main reason for hospitalization being premature rupture of membranes (45%). The analysis revealed a moderate positive correlation between weekly preterm birth incidence and the average temperature (r=0.306, n=52, p=0.027) and a moderate positive correlation between weekly preterm birth incidence and temperature variation (r=0.307, n=52, p=0.007). Our study found no significant statistic correlation between the humidity variation, pressure variation, and wind speed. The incidence of premature births can be influenced by variations of specific weather factors, especially during the weeks characterized by large fluctuations in temperature. The results obtained might inspire the construction of multicenter studies to investigate more thoroughly the adverse effects of some meteorological factors that can influence the outcomes of human pregnancy.

  16. Impact of treatment for bacterial vaginosis on prematurity among Brazilian pregnant women: a retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Rodrigo Pauperio Soares de Camargo

    Full Text Available CONTEXT AND OBJECTIVE: Bacterial vaginosis has been associated with prematurity and other perinatal complications. However, the efficacy of the treatment for preventing such complications has not yet been well established. The objective of this study was to evaluate the impact of treatment for bacterial vaginosis on a low-risk population of Brazilian pregnant women, in order to prevent prematurity and other perinatal complications. DESIGN AND SETTING: Observational retrospective cohort study, at the Obstetric and Gynecology Department, Universidade Estadual de Campinas (Unicamp. METHODS: Vaginal bacterioscopy results from 785 low-risk pregnant women were studied. Three different groups of women were identified: 580 without bacterial vaginosis during pregnancy, 134 with bacterial vaginosis treated using imidazoles (metronidazole, tinidazole, or secnidazole during pregnancy, and 71 with bacterial vaginosis not treated during pregnancy. The diagnosis of bacterial vaginosis was based on Nugent's criteria, from the vaginal bacterioscopy performed during the first prenatal care visit. RESULTS: The frequency of prematurity was 5.5% among the women without bacterial vaginosis, 22.5% among those with untreated bacterial vaginosis and 3.7% among those with treated bacterial vaginosis. The risk ratios for perinatal complications were significantly higher in the group with untreated bacterial vaginosis: premature rupture of membranes, 7.5 (95% CI: 1.9-34.9; preterm labor, 3.4 (95% CI: 1.4-8.1; preterm birth, 6.0 (95% CI: 1.9-19.7; and low birth weight, 4.2 (95% CI: 1.2-14.3. CONCLUSION: The treatment of bacterial vaginosis significantly reduced the rates of prematurity and other perinatal complications among these low-risk Brazilian pregnant women, regardless of the history of previous preterm delivery.

  17. Maternal assessment of pain in premature infants

    Directory of Open Access Journals (Sweden)

    Maria Carolina Correia dos Santos

    2015-12-01

    Full Text Available Objective: to identify mothers' perceptions about the pain in their premature babies in the Neonatal Intensive Care Unit. Methods: evaluative, quantitative study with investigative nature conducted with 19 mothers of hospitalized premature newborns. Data were obtained from closed questions, answered by mothers. Results: from the participants, two (10.5% reported that newborns are unable to feel pain. From the 17 mothers who said that premature babies can feel pain, the majority (94.1% identified crying as a characteristic of pain sensation. Eleven (64.7% stated that uneasiness is a sign of pain in newborns. Conclusion: for the proper management of neonatal pain it is essential that mothers know the signs of pain in premature newborns, and that health professionals instruct this recognition, through the enhancement of the maternal presence and practice of effective communication between professionals and newborns’ families.

  18. Future Applications of Antioxidants in Premature Infants

    Science.gov (United States)

    Lee, Jennifer W.; Davis, Jonathan M.

    2012-01-01

    Purpose of Review This review will examine the unique susceptibility of premature infants to oxidative stress, the role of reactive oxygen species (ROS) in the pathogenesis of common disorders of the preterm infant, and potential for therapeutic interventions using enzymatic and/or non-enzymatic antioxidants. Recent Findings Oxidative stress is caused by an imbalance between the production of ROS and the ability to detoxify them with the help of antioxidants. The premature infant is especially susceptible to ROS-induced damage because of inadequate antioxidant stores at birth, as well as impaired upregulation in response to oxidant stress. Thus, the premature infant is at increased risk for the development of ROS-induced diseases of the newborn, such as bronchopulmonary dysplasia, retinopathy of prematurity, necrotizing enterocolitis, and periventricular leukomalacia. Summary Potential therapies for ROS-induced disease include both enzymatic and non-enzymatic antioxidant preparations. More research is required to determine the beneficial effects of supplemental antioxidant therapy. PMID:21150443

  19. Apnea of prematurity: challenges and solutions

    Directory of Open Access Journals (Sweden)

    Picone S

    2014-06-01

    Full Text Available Simonetta Picone, Roberto Aufieri, Piermichele PaolilloDivision of Neonatology and Neonatal Intensive Care, Department of Maternal and Child Health, Casilino General Hospital, Rome, ItalyAbstract: Apnea of prematurity is a developmental disorder that frequently affects preterm infants, especially those with lower gestational age. Even if apnea of prematurity is by definition a self-limiting condition, it can cause serious problems during the hospital stay and can potentially have long-term neurological and cognitive consequences depending on the severity and intensity of the episodes. The diagnosis of apnea of prematurity can be made only after excluding a number of diseases of the preterm infant in which apnea may be an epiphenomenon. Etiological diagnosis is essential for selection of appropriate treatment, which may be nonpharmacological or involve use of drugs.Keywords: apnea of prematurity, idiopathic and secondary apnea, caffeine

  20. Premature dental eruption: report of case.

    LENUS (Irish Health Repository)

    McNamara, C M

    2011-08-05

    This case report reviews the variability of dental eruption and the possible sequelae. Dental eruption of the permanent teeth in cleft palate children may be variable, with delayed eruption the most common phenomenon. A case of premature dental eruption of a maxillary left first premolar is demonstrated, however, in a five-year-old male. This localized premature dental eruption anomaly was attributed to early extraction of the primary dentition, due to caries.

  1. Neuro-ophthalmic manifestations of prematurity

    OpenAIRE

    Preeti Patil Chhablani; Ramesh Kekunnaya

    2014-01-01

    Increasing rates of preterm births coupled with better survival of these infants have resulted in higher prevalence of systemic and ocular complications associated with prematurity. In addition to retinopathy of prematurity, infants who are born preterm may suffer from severe visual impairment as a result of hypoxic ischemic encephalopathy, hypoglycemia, and other metabolic imbalances. The effect of these processes on the anterior visual pathway may result in optic atrophy, optic nerve hypopl...

  2. PECULIARITIES OF BREAST FEEDING OF PREMATURE CHILDREN

    Directory of Open Access Journals (Sweden)

    V.К. Kotlukov

    2011-01-01

    Full Text Available The article presents main strategies of breast feeding of prematurely born infants support, such as use of Philips AVENT breast pumpfor lactation formation and feeding of the infant with native breast milk.Key words: premature infants, nursing mother, breast feeding support, modern accessories for breast feeding support. (Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (6: 170–175

  3. The pathophysiology of acquired premature ejaculation

    OpenAIRE

    McMahon, Chris G; Jannini, Emmanuele A.; Serefoglu, Ege C.; Hellstrom, Wayne J.G.

    2016-01-01

    The second Ad Hoc International Society for Sexual Medicine (ISSM) Committee for the Definition of Premature Ejaculation defined acquired premature ejaculation (PE) as a male sexual dysfunction characterized by a the development of a clinically significant and bothersome reduction in ejaculation latency time in men with previous normal ejaculatory experiences, often to about 3 minutes or less, the inability to delay ejaculation on all or nearly all vaginal penetrations, and the presence of ne...

  4. Frequency of neonatal complications after premature delivery

    Directory of Open Access Journals (Sweden)

    Gordana Grgić

    2013-04-01

    Full Text Available Introduction: Preterm delivery is the delivery before 37 weeks of gestation are completed. The incidence of preterm birth ranges from 5 to 15%. Aims of the study were to determine the average body weight, Apgar score after one and five minutes, and the frequency of the most common complications in preterminfants.Methods: The study involved a total of 631 newborns, of whom 331 were born prematurely Aims of this study were to (24th-37th gestational weeks-experimental group, while 300 infants were born in time (37-42 weeks of gestation-control group.Results: Average body weight of prematurely born infants was 2382 grams, while the average Apgar score in this group after the fi rst minute was 7.32 and 7.79 after the fifth minute. The incidence of respiratory distress syndrome was 50%, intracranial hemorrhage, 28.1% and 4.8% of sepsis. Respiratory distresssyndrome was more common in infants born before 32 weeks of gestation. Mortality of premature infants is present in 9.1% and is higher than that of infants born at term.Conclusions: Birth body weight and Apgar scores was lower in preterm infants. Respiratory distress syndrome is the most common fetal complication of prematurity. Intracranial hemorrhage is the second most common complication of prematurity. Mortality of premature infants is higher than the mortality of infants born at term birth.

  5. Previable preterm rupture of membranes: gestational and neonatal outcomes.

    Science.gov (United States)

    Margato, Marcela Furlan; Martins, Guilherme Lopes Pinheiro; Passini Júnior, Renato; Nomura, Marcelo Luís

    2012-06-01

    Previable (less than 24 weeks) premature rupture of membranes complicates about 1 in every thousand births and is responsible for substantial perinatal mortality. In this paper, we retrospectively analyzed one twin and 35 singleton pregnancies. Twenty cases occurred before and 16 after 20 weeks. Latency period ranged from 0 to 137 days, with an average of 35 days. Amniotic fluid index was reduced in 27 cases and normal in 6 cases. Expectant management was adopted in 31 cases (86%), five patients declined and opted for termination (14%) at admission or during the course of pregnancy. Steroids were prescribed for 12 patients at or after 24 weeks (39%), leukocyte count at admission varied from 6,000 to 16,200/mm(3), with an average of 11,310, in only 9% it was greater than 15,000, immature forms were present in 10 cases (28%). Clinical chorioamnionitis occurred in 71%, being three times more frequent in parous women. Bacteriuria was present in 2 of 30 cases (6.6%). Two women developed laboratorial and clinical signs of sepsis, none of them needed hysterectomy. There were no maternal deaths. Mean gestational age at delivery was 24 weeks, ranging from 16 to 39 weeks. In the expectant group, preterm delivery rate was 68%. There was one case of abruption. Cesarean rate was 31%. Neonatal mortality was 42% (8 cases). Overall neonatal survival was 35% (11 in 32 newborns). Perinatal mortality is high in pregnancies complicated by previable rupture of membranes, however gestational age at occurrence is a strong predictor of outcome. An individualized approach is the best management option regarding maternal risks and fetal outcomes.

  6. Misdiagnosed Chest Pain: Spontaneous Esophageal Rupture

    Science.gov (United States)

    Inci, Sinan; Gundogdu, Fuat; Gungor, Hasan; Arslan, Sakir; Turkyilmaz, Atila; Eroglu, Atila

    2013-01-01

    Chest pain is one of themost common complaints expressed by patients presenting to the emergency department, and any initial evaluation should always consider life-threatening causes. Esophageal rupture is a serious condition with a highmortality rate. If diagnosed, successful therapy depends on the size of the rupture and the time elapsed between rupture and diagnosis.We report on a 41-year-old woman who presented to the emergency department complaining of left-sided chest pain for two hours. PMID:27122690

  7. Patellar tendon: From tendinopathy to rupture

    Directory of Open Access Journals (Sweden)

    Federica Rosso

    2015-10-01

    Full Text Available Patellar tendinopathy is very common in patients complaining of anterior knee pain. Its aetiology is still unclear, but neovascularisation seems to play a role. Different treatments have been proposed overtime, from rehabilitation to platelet-rich-plasma injections, but there is no agreement on the best treatment protocol. The final stage of patellar tendinopathy is patellar tendon rupture. In these cases surgical treatment is often required. The aim of this literature review is to focus on the aetiology, diagnosis, and treatment of both patellar tendinopathy and rupture. We report the conservative treatments proposed for patellar tendinopathy and the surgical techniques described for its rupture.

  8. Plantar fascia rupture: diagnosis and treatment.

    Science.gov (United States)

    Rolf, C; Guntner, P; Ericsäter, J; Turan, I

    1997-01-01

    Two patients with spontaneous medial plantar fascia rupture due to a definite injury with no prior symptoms, were referred to our institution. Clinically, there was a tender lump in the sole, and magnetic resonance imaging confirmed the diagnosis. Nonoperative treatment was sufficient in curing the acute total rupture. Endoscopic release was used on the partially ruptured plantar fascia, but it is probably more optimal in the acute phase. The literature provides no comparative data on operative or nonoperative treatment efficacy for this rare condition.

  9. RUPTURED RUDIMENTARY HORN PREGNANCY OF UNICORNUATE UTERUS

    Directory of Open Access Journals (Sweden)

    Vijay Kumar

    2015-06-01

    Full Text Available Unicornuate uterus can sometimes be associated with rudimentary horn. Pregnancy in a rudimentary horn is rare and usually ends up in rupture. Diagnosis is difficult and can be missed in routine ultrasound scan and is usually detected after rupture. We report a case of G1P1 with rudimentary horn pregnancy which raised suspicion on ultr asound and was later diagnosed by MR imaging. Patient refused termination and presented next day with shock. Laparotomy revealed ruptured right rudimentary horn pregnancy.

  10. Gastric rupture after the Heimlich maneuver.

    Science.gov (United States)

    Bintz, M; Cogbill, T H

    1996-01-01

    Since 1975, the Heimlich maneuver has been widely applied to relieve upper airway obstruction caused by aspirated material. Life-threatening complications have been documented following this simple procedure. We report two cases of gastric rupture after use of the Heimlich maneuver. Both patients experienced pulmonary and abdominal symptoms. The diagnosis was confirmed in each case by the demonstration of free intraperitoneal air on an upright chest roentgenogram. Full-thickness gastric rupture along the lesser curvature of the stomach was repaired in both patients; one patient died. Abdominal pain or persistent abdominal distention despite nasogastric suction after the Heimlich maneuver should prompt evaluation for possible gastric rupture.

  11. Premature Ejaculation and Utilization of Cognitive Techniques

    Directory of Open Access Journals (Sweden)

    Serkan AKKOYUNLU

    2013-03-01

    Full Text Available Introduction: Premature ejaculation is the most common male sexual dysfunction leading to distress in many couples. Master and Johnson emphasized the concept of early learned experiences and Kaplan emphasized lack of sensory awareness. For treatment sex therapists mainly utilize start-stop and squeeze techniques as homework. Couples enter sex therapy with some cognitive distortions and beliefs about sex and sexuality. These beliefs are also named sexual myths. For some couples using techniques to challenge cognitive distortions and maladaptive beliefs about sex and sexuality can be used. In this paper by presenting a case we discussed how cognitive techniques can be used along with behaviour techniques with couples. Case: Presenting clients are five years married couple who are thirty and twenty nine years old respectively. They attended to the outpatient clinic with the request of the female client. Their main complaint was premature ejaculation. They were diagnosed premature ejaculation using clinical interview. In treatment besides start and stop technique, cognitive techniques were utilized to address dysfunctional beliefs about sexuality. Discussion: Premature ejaculation is a male sexual dysfunction that causes distress and intimacy problems between couples. Stop start and squeeze techniques were accepted as the choice of treatment but their effectiveness is questioned recently. Also cognitive distortions and maladaptive beliefs may hamper therapy progress. Besides that, behavioral techniques utilizing cognitive techniques to lessen the degree of dysfunctional beliefs about sex and sexuality may help the couple to overcome premature ejaculation and enhance sexual satisfaction and intimacy.

  12. Spontaneous rupture of ovarian cystadenocarcinoma: pre- and post-rupture computed tomography evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Salvadori, Priscila Silveira; Atzingen, Augusto Castelli von; D' Ippolito, Giuseppe [Universidade Federal de Sao Paulo (EPM/UNIFESP), Sao Paulo, SP (Brazil). Escola Paulista de Medicina; Bomfim, Lucas Novais [Universidade Tiradentes (UNIT), Maceio, AL, (Brazil)

    2015-09-15

    Epithelial ovarian tumors are the most common malignant ovarian neoplasms and, in most cases, eventual rupture of such tumors is associated with a surgical procedure. The authors report the case of a 54-year-old woman who presented with spontaneous rupture of ovarian cystadenocarcinoma documented by computed tomography, both before and after the event. In such cases, a post-rupture staging tends to be less favorable, compromising the prognosis. (author)

  13. Creep-rupture reliability analysis

    Science.gov (United States)

    Peralta-Duran, A.; Wirsching, P. H.

    1985-01-01

    A probabilistic approach to the correlation and extrapolation of creep-rupture data is presented. Time temperature parameters (TTP) are used to correlate the data, and an analytical expression for the master curve is developed. The expression provides a simple model for the statistical distribution of strength and fits neatly into a probabilistic design format. The analysis focuses on the Larson-Miller and on the Manson-Haferd parameters, but it can be applied to any of the TTP's. A method is developed for evaluating material dependent constants for TTP's. It is shown that optimized constants can provide a significant improvement in the correlation of the data, thereby reducing modelling error. Attempts were made to quantify the performance of the proposed method in predicting long term behavior. Uncertainty in predicting long term behavior from short term tests was derived for several sets of data. Examples are presented which illustrate the theory and demonstrate the application of state of the art reliability methods to the design of components under creep.

  14. Achilles tendon rupture in atypical patient populations.

    Science.gov (United States)

    Kingsley, Peter

    2016-03-01

    Rupture of the Achilles tendon is a significant injury, and the likelihood of a good recovery is directly associated with early diagnosis and appropriate referral. Such injuries are commonly assessed and identified by practitioners working in 'minors' areas of emergency departments or urgent care settings. The literature frequently describes rupture of the Achilles tendon as 'typically sport-related' affecting 'middle-aged weekend warriors', but this aetiology accounts for only about 70% of such injuries. Factors such as the natural ageing process, obesity and use of some commonly prescribed medications, can increase the risk of developing a tendinopathy and subsequent rupture, often from a seemingly insignificant incident. However, research suggests that injuries in this patient population are more likely be missed on first examination. This article describes risk factors that should alert clinicians to the possibility of Achilles tendon rupture in 'atypical' patient populations.

  15. Spontaneous splenic rupture in typhoid fever.

    OpenAIRE

    Ali, G; Kamili, M. A.; Rashid, S; Mansoor, A; Lone, B. A.; Allaqaband, G. Q.

    1994-01-01

    Three cases of multidrug-resistant Salmonella typhi infection presenting as spontaneous splenic rupture are presented. One patient died and two recovered completely. This is a previously unreported presentation of typhoid fever.

  16. Right Diaphragm Spontaneous Rupture: A Surgical Approach

    Directory of Open Access Journals (Sweden)

    Duilio Divisi

    2011-01-01

    Full Text Available We present a case of spontaneous rupture of the diaphragm, characterized by nonspecific symptoms. The rapid diagnosis and appropriate surgical approach led to a positive resolution of the pathology.

  17. Cognitive frames in psychology: demarcations and ruptures.

    Science.gov (United States)

    Yurevich, Andrey V

    2009-06-01

    As there seems to be a recurrent feeling of crisis in psychology, its present state is analyzed in this article. The author believes that in addition to the traditional manifestations that have dogged psychology since it emerged as an independent science some new features of the crisis have emerged. Three fundamental "ruptures" are identified: the "horizontal" rupture between various schools and trends, the "vertical" rupture between natural science and humanitarian psychology, and the "diagonal" rupture between academic research and applied practice of psychology. These manifestations of the crisis of psychology have recently been compounded by the crisis of its rationalistic foundations. This situation is described in terms of the cognitive systems in psychology which include meta-theories, paradigms, sociodigms and metadigms.

  18. Uterine rupture without previous caesarean delivery

    DEFF Research Database (Denmark)

    Thisted, Dorthe L. A.; H. Mortensen, Laust; Krebs, Lone

    2015-01-01

    .3/100,000 deliveries. Multiparity (RR 8.99 (95% CI 1.86-43.29)), induction of labour (RR 3.26 (95% CI 1.24-8.57)), epidural analgesia (RR 10.78 (95% CI 4.25-27.39)), and augmentation by oxytocin (RR 9.50 (95% CI 3.15-28.63)) were associated with uterine rupture. Induction of labour was not significantly related...... to uterine rupture when adjusted for parity, epidural analgesia and augmentation by oxytocin. CONCLUSION: Although uterine rupture is rare, its association with epidural analgesia and augmentation of labour with oxytocin in multipara should be considered. Thus, vigilance should be exercised when labour...... is obstructed and there is need for epidural analgesia and/or augmentation by oxytocin in multiparous women. Due to the rare occurrence of uterine rupture caution should be exerted when interpreting the findings of this study....

  19. Micromechanical properties and collagen composition of ruptured human achilles tendon

    DEFF Research Database (Denmark)

    Hansen, Philip; Kovanen, Vuokko; Hölmich, Per

    2013-01-01

    The Achilles tendon is one of the strongest tendons in the human body, and yet it frequently ruptures, which is a substantial clinical problem. However, the cause of ruptures remains elusive.......The Achilles tendon is one of the strongest tendons in the human body, and yet it frequently ruptures, which is a substantial clinical problem. However, the cause of ruptures remains elusive....

  20. Quadriceps tendon rupture through a superolateral bipartite patella.

    Science.gov (United States)

    Woods, G William; O'Connor, Daniel P; Elkousy, Hussein A

    2007-10-01

    We report a case of a quadriceps tendon rupture through a bipartite patella. Although quadriceps tendon ruptures and patella fractures are common, rupture through a bipartite patella fragment is rare. This case was managed similar to a quadriceps rupture with an excellent result.

  1. Aortic ruptures in seat belt wearers.

    Science.gov (United States)

    Arajärvi, E; Santavirta, S; Tolonen, J

    1989-09-01

    Several investigations have indicated that rupture of the thoracic aorta is one of the leading causes of immediate death in victims of road traffic accidents. In Finland in 1983, 92% of front-seat passengers were seat belt wearers on highways and 82% in build-up areas. The mechanisms of rupture of the aorta have been intensively investigated, but the relationship between seat belt wearing and injury mechanisms leading to aortic rupture is still largely unknown. This study comprises 4169 fatally injured victims investigated by the Boards of Traffic Accident Investigation of Insurance Companies during the period 1972 to 1985. Chest injuries were recorded as the main cause of death in 1121 (26.9%) victims, 207 (5.0%) of those victims having worn a seat belt. Aortic ruptures were found at autopsy in 98 victims and the exact information of the location of the aortic tears was available in 68. For a control group, we analyzed 72 randomly chosen unbelted victims who had a fatal aortic rupture in similar accidents. The location of the aortic rupture in unbelted victims was more often in the ascending aorta, especially in drivers, whereas in seat belt wearers the distal descending aorta was statistically more often ruptured, especially in right-front passengers (p less than 0.05). The steering wheel predominated statistically as the part of the car estimated to have caused the injury in unbelted victims (37/72), and some interior part of the car was the most common cause of fatal thoracic impacts in seat belt wearers (48/68) (p less than 0.001). The mechanism of rupture of the aorta in the classic site just distal to the subclavian artery seems to be rapid deceleration, although complex body movements are also responsible in side impact collisions. The main mechanism leading to rupture of the ascending aorta seems to be severe blow to the bony thorax. This also often causes associated thoracic injuries, such as heart rupture and sternal fracture. Injuries in the ascending

  2. Blunt cardiac rupture in a toddler

    Directory of Open Access Journals (Sweden)

    Peep Talving

    2016-08-01

    Full Text Available Blunt cardiac rupture is typically a fatal injury with overall mortality exceeding 90%. Most of the patients never reach the hospital alive. In pediatric patients, only 0.03% of cases following blunt trauma admissions have a cardiac injury. This report presents a rare survivor of 16-months old toddler injured in a domestic accident suffering a right atrial rupture repaired through a median sternotomy. To the best of our knowledge this is the youngest case reported in the literature.

  3. Serum fructosamine and retinopathy of prematurity.

    Science.gov (United States)

    Bozdag, Senol; Oguz, Serife Suna; Gokmen, Tulin; Tunay, Zuhal; Tok, Levent; Uras, Nurdan; Erdeve, Omer; Dilmen, Ugur

    2011-12-01

    To determine whether serum fructosamine which is a good marker for detecting hyperglycemia during the previous 2 to 3 wk in infants could predict the development of retinopathy of prematurity in very low birth weight infants. One hundred sixty seven premature infants who had a birth weight of < 1500 g and a gestational age of less than 32 wk were investigated in the present study. Blood glucose was measured at the bedside and infants were recorded as hyperglycemic if their mean blood glucose levels were higher than 150 mg/dL. Serum corrected fructosamine level was obtained from the cord blood at birth and after the first month of life. The infants' eyes were examined by ophthalmologists to detect retinopathy of prematurity at the gestational age of 32 wk or at four wk after birth, whichever came first. Corrected fructosamine was 319.6 ± 59.6 and 272.8 ± 50.6 mmol/l for group 1 on 1(st) and 30(th) day respectively; 320 ± 61.7 and 268.2 ± 47.3 mmol/l for groups 2 + 3 on 1(st) and 30(th) day respectively which did not differ between groups (p = 0.766 and p = 0.665), whereas duration of hyperglycemia was 1.69 ± 1.1 day in group 1 compared with 3.05 ± 2.4 day in groups 2 + 3 which was significantly different (p = 0.019). The multivariate regression analysis indicated that the duration of hyperglycemia in days was significantly correlated with the development of retinopathy of prematurity (OR 3.26; 95% CI 1.09-9.80; p = 0.035). Although the duration of hyperglycemia may contribute to the development of retinopathy of prematurity, serum corrected fructosamine does not have a good predictive value in developing retinopathy of prematurity in very-low-birth-weight (VLBW) infants.

  4. The circadian variation of premature atrial contractions

    DEFF Research Database (Denmark)

    Larsen, Bjørn Strøier; Kumarathurai, Preman; Nielsen, Olav W

    2016-01-01

    AIMS: The aim of the study was to assess a possible circadian variation of premature atrial contractions (PACs) in a community-based population and to determine if the daily variation could be used to assess a more vulnerable period of PACs in predicting later incidence of atrial fibrillation (AF...... variation in heart rate. After adjusting for relevant risk factors, the risk of AF was equal in all time intervals throughout the day. CONCLUSION: Premature atrial contractions showed a circadian variation in subjects with frequent PACs. No specific time interval of the day was more predictive of AF than...

  5. Intra-amniotic infection/inflammation as a risk factor for subsequent ruptured membranes after clinically indicated amniocentesis in preterm labor.

    Science.gov (United States)

    Lee, Sung Youn; Park, Kyo Hoon; Jeong, Eun Ha; Oh, Kyung Joon; Ryu, Aeli; Kim, Ahra

    2013-08-01

    The aim of this study was to determine whether intra-amniotic infection/inflammation (IAI) was associated with subsequent ruptured membranes in women with preterm labor and intact membranes who had a clinically indicated amniocentesis. This retrospective cohort study included 237 consecutive women with preterm labor (20-34.6 weeks) who underwent amniocentesis. The clinical and laboratory parameters evaluated included demographic variables, gestational age, C-reactive protein (CRP) and amniotic fluid (AF) white blood cell, interleukin-6 (IL-6) and culture results. IAI was defined as a positive AF culture and/or an elevated AF IL-6 level (>2.6 ng/mL). The primary outcome was ruptured membranes in the absence of active labor occurring within 48 hours of amniocentesis. Preterm premature rupture of membranes subsequently developed in 10 (4.2%) women within 48 hr of amniocentesis. Multivariate analysis demonstrated that only IAI was independently associated with the ruptured membranes occurring within 48 hr of amniocentesis. In the predictive model based on variables assessed before amniocentesis, only CRP level was retained. IAI is an independent risk factor for subsequent ruptured membranes after clinically indicated amniocentesis in preterm labor. Prior to amniocentesis, measurement of serum CRP level can provide a risk assessment for the subsequent development of ruptured membranes after the procedure.

  6. The roentgenographic findings of achilles tendon rupture

    Energy Technology Data Exchange (ETDEWEB)

    Seouk, Kang Hyo; Keun, Rho Yong [Shilla General Hospital, Seoul (Korea, Republic of)

    1999-03-01

    To evaluate the diagnostic value of a lateral view of the ankles in Achilles tendon rupture. We performed a retrospective analysis of the roentgenographic findings of 15 patients with surgically proven Achilles tendon rupture. Four groups of 15 patients(normal, ankle sprain, medial lateral malleolar fracture, and calcaneal fracture) were analysed as reference groups. Plain radiographs were reviewed with regard to Kager's triangle, Arner's sign, Toygar's angle, ill defined radiolucent shadow through the Achilles tendon, sharpness of the anterior margin of Achilles tendon, and meniscoid smooth margin of the posterior skin surface of the ankle. Kager's triangle was deformed and disappeared after rupture of the Achilles tendon in nine patients(60%) with operative verification of the rupture, six patients(40%) had a positive Arner's sign, while none had a diminished Toygars angle. In 13 patients(87%) with a ruptured Achilles tendon, the thickness of this was nonuniform compared with the reference group. The anterior margin of the Achilles tendon became serrated and indistinct in 14 patients(93%) in whom this was ruptured. An abnormal ill defined radiolucent shadow through the Achilles tendon was noted in nine patient(60%), and nonparallelism between the anterior margin of the Achilles tendon and posterior skin surface of the ankle was detected in 11 patients(73%). The posterior skin surface of the ankle had a nodular surface margin in 13 patients(87%). A deformed Kager's triangle and Achilles tendon, and an abnormal ill defined radiolucent shadow through the Achilles tendon in a lateral view of the ankles are important findings for the diagnesis of in diagnosing achilles tendon rupture.

  7. General Considerations of Ruptured Abdominal Aortic Aneurysm: Ruptured Abdominal Aortic Aneurysm

    OpenAIRE

    Lee, Chung Won; Bae, Miju; Chung, Sung Woon

    2015-01-01

    Although development of surgical technique and critical care, ruptured abdominal aortic aneurysm still carries a high mortality. In order to obtain good results, various efforts have been attempted. This paper reviews initial management of ruptured abdominal aortic aneurysm and discuss the key point open surgical repair and endovascular aneurysm repair.

  8. AMH as Predictor of Premature Ovarian Insufficiency

    DEFF Research Database (Denmark)

    Lunding, Stine Aa; Aksglæde, Lise; Anderson, Richard A

    2015-01-01

    CONTEXT: The majority of Turner syndrome (TS) patients suffer from accelerated loss of primordial follicles. Low circulating levels of anti-Müllerian hormone (AMH) may predict the lack of spontaneous puberty in prepubertal girls and imminent premature ovarian insufficiency (POI) in TS women...

  9. Premature ovarian failure and ovarian autoimmunity

    NARCIS (Netherlands)

    J.A. Schoemaker (Joop); H.A. Drexhage (Hemmo); A. Hoek (Annemieke)

    1997-01-01

    textabstractPremature ovarian failure (POF) is defined as a syndrome characterized by menopause before the age of 40 yr. The patients suffer from anovulation and hypoestrogenism. Approximately 1% of women will experience menopause before the age of 40 yr. POF is a

  10. [Nontraumatic chylopericardium and chylothorax in premature neonates].

    Science.gov (United States)

    Avrel'kina, E A; Ignat'eva, E N; Fediarova, M A; Pliukhin, S V

    2014-01-01

    Deaths of extremely premature babies undiagnosed as having spontaneous chylopericardium (CP) and chylothorax (CT) are analyzed. The specific features of these death cases are the polyetiology of CP/CT and the similarity of their pathogenesis in the absence of specific clinical symptomatology.

  11. Catheter ablation of parahisian premature ventricular complex.

    Science.gov (United States)

    Kim, Jun; Kim, Jeong Su; Park, Yong Hyun; Kim, June Hong; Chun, Kook Jin

    2011-12-01

    Catheter ablation is performed in selected patients with a symptomatic premature ventricular complex (PVC) or PVC-induced cardiomyopathy. Ablation of PVC from the His region has a high risk of inducing a complete atrioventricular block. Here we report successful catheter ablation of a parahisian PVC in a 63-year-old man.

  12. Liver Abscess: Increasing Occurrence in Premature Newborns

    Directory of Open Access Journals (Sweden)

    OKTAV BOSNALI

    2013-03-01

    Full Text Available Neonatal liver abscess is a very rare condition associated with high morbidity and mortality rates. There seems to be an increasing trend of this rare condition amongst the newborns admitted to neonatal intensive care units. We report a case of liver abscess in a premature newborn and briefly review the literature and discuss its management.

  13. Liver Abscess: Increasing Occurrence in Premature Newborns

    Science.gov (United States)

    Bosnalı, Oktav; Moralıoğlu, Serdar; Pektaş, Osman

    2013-01-01

    Neonatal liver abscess is a very rare condition associated with high morbidity and mortality rates. There seems to be an increasing trend of this rare condition amongst the newborns admitted to neonatal intensive care units. We report a case of liver abscess in a premature newborn and briefly review the literature and discuss its management. PMID:26023443

  14. Liver Abscess: Increasing Occurrence in Premature Newborns

    Directory of Open Access Journals (Sweden)

    Oktav Bosnalı

    2013-04-01

    Full Text Available Neonatal liver abscess is a very rare condition associated with high morbidity and mortality rates. There seems to be an increasing trend of this rare condition amongst the newborns admitted to neonatal intensive care units. We report a case of liver abscess in a premature newborn and briefly review the literature and discuss its management.

  15. Premature mortality in Japan due to ozone

    Science.gov (United States)

    Nawahda, Amin; Yamashita, Ken; Ohara, Toshimasa; Kurokawa, Junichi; Ohizumi, Tsuyoshi; Chen, Fang; Akimoto, Hajime

    2013-12-01

    In Japan, all 47 prefectures conduct routine air quality monitoring at 1145 stations throughout the country to assess environmental effects. This study aims to provide a better understanding of possible estimations of premature mortality in Japan caused by exposure to monitored and modeled concentrations of tropospheric ozone during the period from January to December, 2005. The spatial distribution and temporal variation of ozone concentrations were modeled using the Models-3 Community Multiscale Air Quality modeling system coupled with the Regional Emission Inventory in Asia (CMAQ/REAS). Premature mortality caused by exposure to ozone was calculated assuming a relative risk (RR) value of 1.003 [95% Confidence Interval (CI): 1.001-1.004] for concentrations above 35 ppb according to the SOMO35 index (annual Sum of daily maximum 8-h Ozone Means Over 35 ppb) recommended by WHO (2008). Based on CMAQ/REAS simulations, the estimated all-cause premature mortality in 2005 is about 13,000 (95% CI: 4320-17,300) cases. This value is 2.5 times greater than the estimated premature mortality based on monitored ozone concentrations, which is 5220 (95% CI: 1740-6960) cases.

  16. Optimal oxygen saturation in premature infants

    Directory of Open Access Journals (Sweden)

    Meayoung Chang

    2011-09-01

    Full Text Available There is a delicate balance between too little and too much supplemental oxygen exposure in premature infants. Since underuse and overuse of supplemental oxygen can harm premature infants, oxygen saturation levels must be monitored and kept at less than 95% to prevent reactive oxygen species-related diseases, such as retinopathy of prematurity and bronchopulmonary dysplasia. At the same time, desaturation below 80 to 85% must be avoided to prevent adverse consequences, such as cerebral palsy. It is still unclear what range of oxygen saturation is appropriate for premature infants; however, until the results of further studies are available, a reasonable target for pulse oxygen saturation (SpO2 is 90 to 93% with an intermittent review of the correlation between SpO2 and the partial pressure of arterial oxygen tension (PaO2. Because optimal oxygenation depends on individuals at the bedside making ongoing adjustments, each unit must define an optimal target range and set alarm limits according to their own equipment or conditions. All staff must be aware of these values and adjust the concentration of supplemental oxygen frequently.

  17. New Information About Premature Births (For Consumers)

    Centers for Disease Control (CDC) Podcasts

    2006-10-06

    A new study finds that prematurity is the most frequent cause of infant death in the United States. Learn more.  Created: 10/6/2006 by CDC Division of Reproductive Health.   Date Released: 10/6/2006.

  18. Human cytomegalovirus infections in premature infants by ...

    African Journals Online (AJOL)

    Owner

    clinical importance of CMV infection in premature infants by breast-feeding is still unclear. This mini- ... Transmission of CMV by natural routes relates ... infection from the fresh breast milk containing the virus. ... As a result of transmission during the course of delivery ... hepatitis was speculated to be caused by primary.

  19. Premature ovarian failure and ovarian autoimmunity

    NARCIS (Netherlands)

    J.A. Schoemaker (Joop); H.A. Drexhage (Hemmo); A. Hoek (Annemieke)

    1997-01-01

    textabstractPremature ovarian failure (POF) is defined as a syndrome characterized by menopause before the age of 40 yr. The patients suffer from anovulation and hypoestrogenism. Approximately 1% of women will experience menopause before the age of 40 yr. POF is a heter

  20. Premature ovarian failure and ovarian autoimmunity

    NARCIS (Netherlands)

    J.A. Schoemaker (Joop); H.A. Drexhage (Hemmo); A. Hoek (Annemieke)

    1997-01-01

    textabstractPremature ovarian failure (POF) is defined as a syndrome characterized by menopause before the age of 40 yr. The patients suffer from anovulation and hypoestrogenism. Approximately 1% of women will experience menopause before the age of 40 yr. POF is a heter

  1. Laterality in Prematurely-Born Children.

    Science.gov (United States)

    Segalwitz, Sidney J.; Chapman, Jacqueline S.

    The study examined the relationship between perinatal stress and decreased right handedness and decreased left cerebral dominance for speech with 215 children born prematurely, followed from birth, and tested at age 5. Results indicated that neither hand preference nor hand performance correlated with degree of perinatal stress and that eye…

  2. Acute renal failure in premature neonates

    Directory of Open Access Journals (Sweden)

    Doronjski Aleksandra

    2009-01-01

    Full Text Available Background/Aim. Hemodynamic stress is the leading cause of acute renal failure (ARF in premature neonates. Incidence of ARF in this population is between 8 and 24%. The aim of this study was to determine the frequency of presence of ARF in premature neonates, as well as its impact on their survival. Methods. A retrospective study of 114 premature neonates [(gestational age, GA less than 37 gestation weeks (gw] admitted to the Intensive Care Unit (ICU at the Pediatric Clinic, Institute of Child and Youth Healthcare of Vojvodina in 2007 was conducted. Serum creatinine, urea and bilirubine were determined on the 3rd day of life in 65 newborns who met inclusion criteria. ARF was diagnosed in 16 newborns (n=16/65; 25%. Results. The premature neonates with ARF had significantly lower GA [<28 gw - 8/16 (50% vs. 5/49 (10%; p < 0.05], birth weight (BW (1 265 g vs. 1615 g; p < 0.05 and systolic blood pressure (43.37 mm Hg vs. 52.7 mmHg; p < 0.05 than ones without ARF. Non-olyguric ARF was diagnosed in 62% of newborns with ARF (n=10/16, while the rest had the olyguric type (n = 6/16; 38%. Twenty-five percent of premature neonates with ARF (n = 4/16 died in contrast to 10% of premature neonates without ARF (n = 5/49. ARF was treated conservatively in all but 3 cases when peritoneal dialysis was performed. Renal function has recovered completely in all of the survivors. In order to determine their predictivity in relation to ARF, following parameters were analyzed: GA, BW < 1 500 g, presence of concomitant sepsis and intracranial hemorrhage grade III/IV. BW < 1 500 g demonstrated the highest sensitivity (se 0.75, while GA < 28 gw, sepsis and intracranial hemorrhage grade III/IV showed high specificity (sp = 0.90, 0.89 0.88, respectively. Conclusion. Acute renal failure frequently occurs in population of premature neonates and requires meticulous fluid and electrolyte balance, especially in the case of low birth weight and extreme immaturity.

  3. Impact of rotavirus vaccine on premature infants.

    Science.gov (United States)

    Roué, Jean-Michel; Nowak, Emmanuel; Le Gal, Grégoire; Lemaitre, Thomas; Oger, Emmanuel; Poulhazan, Elise; Giroux, Jean-Dominique; Garenne, Armelle; Gagneur, Arnaud

    2014-10-01

    Infants born preterm are at a higher risk of complications and hospitalization in cases of rotavirus diarrhea than children born at term. We evaluated the impact of a rotavirus vaccination campaign (May 2007 to May 2010) on hospitalizations for rotavirus gastroenteritis in a population of children under 3 years old born prematurely (before 37 weeks of gestation) in the Brest University Hospital birth zone. Active surveillance from 2002 to 2006 and a prospective collection of hospitalizations for rotavirus diarrhea were initiated in the pediatric units of Brest University Hospital until May 2010. Numbers of hospitalizations for rotavirus diarrhea among the population of children born prematurely, before and after the start of the vaccination program, were compared using a Poisson regression model controlling for epidemic-to-epidemic variation. A total of 217 premature infants were vaccinated from 2007 to 2010. Vaccine coverage for a complete course of three doses was 41.9%. The vaccine safety in premature infants was similar to that in term infants. The vaccination program led to a division by a factor of 2.6 (95% confidence interval [CI], 1.3 to 5.2) in the number of hospitalizations for rotavirus diarrhea during the first two epidemic seasons following vaccine introduction and by a factor of 11 (95% CI, 3.5 to 34.8) during the third season. We observed significant effectiveness of the pentavalent rotavirus vaccine on the number of hospitalizations in a population of prematurely born infants younger than 3 years of age. A multicenter national study would provide better assessment of this impact. (This study [Impact of Systematic Infants Vaccination Against Rotavirus on Gastroenteritis Hospitalization: a Prospective Study in Brest District, France (IVANHOE)] has been registered at ClinicalTrials.gov under registration no. NCT00740935.).

  4. Light microscopic histology of quadriceps tendon ruptures.

    Science.gov (United States)

    Maffulli, Nicola; Del Buono, Angelo; Spiezia, Filippo; Longo, Umile Giuseppe; Denaro, Vincenzo

    2012-11-01

    To assess histological changes and possible differences in the quadriceps of patients undergoing open repair of the tendon after spontaneous rupture, and subjects with no history of tendon pathology. Biopsies were harvested from the quadriceps tendon of 46 patients (34 men, 12 women) who had reported unilateral atraumatic quadriceps tendon rupture and had undergone surgical repair of the tendon. Samples were also harvested from both the tendons in 11 (N = 11 × 2) patients, nine males and two females, dying from cardiovascular disorders. For each tendon, three slides were randomly selected and examined under light microscopy, and assessed using a semiquantitative grading scale (range 0-21) which considers fibre structure, fibre arrangement, rounding of the nuclei, regional variations in cellularity, increased vascularity, decreased collagen stainability, and hyalinisation. The pathological sum-score averaged 19.2 ± 3.7 in ruptured tendons and 5.6 ± 2.0 in controls, and all variables considered were significantly different between the two groups, showing an association between tendon abnormalities and rupture (0.05 tendons increases the risk of rupture.

  5. Endovascular repair of ruptured abdominal aortic aneurysm

    Directory of Open Access Journals (Sweden)

    Šarac Momir

    2014-01-01

    Full Text Available Introduction. Rupture of an abdominal aortic aneurysm (AAA is a potentially lethal state. Only half of patients with ruptured AAA reach the hospital alive. The alternative for open reconstruction of this condition is endovascular repair (EVAR. We presented a successful endovascular reapir of ruptured AAA in a patient with a number of comorbidities. Case report. A 60-year-old man was admitted to our institution due to diffuse abdominal pain with flatulence and belching. Initial abdominal ultrasonography showed an AAA that was confirmed on multislice computed tomography scan angiography which revealed a large retroperitoneal haematoma. Because of patient’s comorbidites (previous surgery of laryngeal carcinoma and one-third laryngeal stenosis, arterial hypertension and cardiomyopathy with left ventricle ejection fraction of 30%, stenosis of the right internal carotid artery of 80% it was decided that endovascular repair of ruptured AAA in local anaesthesia and analgosedation would be treatment of choice. Endovascular grafting was achieved with aorto-bi-iliac bifurcated excluder endoprosthesis with complete exclusion of the aneurysmal sac, without further enlargment of haemathoma and no contrast leakage. The postoperative course of the patient was eventless, without complications. On recall examination 3 months after, the state of the patient was well. Conclusion. The alternative for open reconstruction of ruptured AAA in haemodynamically stable patients with suitable anatomy and comorbidities could be emergency EVAR in local anesthesia. This technique could provide greater chances for survival with lower intraoperative and postoperative morbidity and mortality, as shown in the presented patient.

  6. Dynamic rupture processes inferred from laboratory microearthquakes

    Science.gov (United States)

    Passelègue, François. X.; Schubnel, Alexandre; Nielsen, Stefan; Bhat, Harsha S.; Deldicque, Damien; Madariaga, Raúl

    2016-06-01

    We report macroscopic stick-slip events in saw-cut Westerly granite samples deformed under controlled upper crustal stress conditions in the laboratory. Experiments were conducted under triaxial loading (σ1>σ2=σ3) at confining pressures (σ3) ranging from 10 to 100 MPa. A high-frequency acoustic monitoring array recorded particle acceleration during macroscopic stick-slip events allowing us to estimate rupture speed. In addition, we record the stress drop dynamically and we show that the dynamic stress drop measured locally close to the fault plane is almost total in the breakdown zone (for normal stress >75 MPa), while the friction f recovers to values of f > 0.4 within only a few hundred microseconds. Enhanced dynamic weakening is observed to be linked to the melting of asperities which can be well explained by flash heating theory in agreement with our postmortem microstructural analysis. Relationships between initial state of stress, rupture velocities, stress drop, and energy budget suggest that at high normal stress (leading to supershear rupture velocities), the rupture processes are more dissipative. Our observations question the current dichotomy between the fracture energy and the frictional energy in terms of rupture processes. A power law scaling of the fracture energy with final slip is observed over 8 orders of magnitude in slip, from a few microns to tens of meters.

  7. Birthing and Parenting a Premature Infant in a Cultural Context

    Science.gov (United States)

    Brooks, Jada L.; Holdtich-Davis, Diane; Docherty, Sharron L.; Theodorou, Christina S.

    2015-01-01

    The purpose of this longitudinal qualitative descriptive study was to explore American Indian (AI) mothers’ perceptions of parenting their premature infants over their first year of life in the context of their culture, including the birth and hospitalization experience. A convenience sample of 17 AI mothers and their premature infants were recruited from either a neonatal intensive care unit (NICU) or pediatric clinic in the southeast. Semistructured interviews were conducted at two time points. Through content analytic methods, three broad categories were revealed: descriptions of having a premature infant in the NICU, descriptions of parenting a premature infant, and the influence of Lumbee culture on parenting a premature infant. Certain aspects of AI culture appear to be important in having a premature infant in the NICU and in parenting a premature infant. We recommend that healthcare providers deliver culturally appropriate care that fully supports AI mothers and their premature infants. PMID:25721716

  8. Birthing and Parenting a Premature Infant in a Cultural Context.

    Science.gov (United States)

    Brooks, Jada L; Holdtich-Davis, Diane; Docherty, Sharron L; Theodorou, Christina S

    2016-02-01

    The purpose of this longitudinal qualitative descriptive study was to explore American Indian mothers' perceptions of parenting their premature infants over their first year of life in the context of their culture, including the birth and hospitalization experience. A convenience sample of 17 American Indian mothers and their premature infants were recruited from either a neonatal intensive care unit (NICU) or pediatric clinic in the southeast. Semistructured interviews were conducted at two time points. Through content analytic methods, three broad categories were revealed: descriptions of having a premature infant in the NICU, descriptions of parenting a premature infant, and the influence of Lumbee culture on parenting a premature infant. Certain aspects of American Indian culture appear to be important in having a premature infant in the NICU and in parenting a premature infant. We recommend that health care providers deliver culturally appropriate care that fully supports American Indian mothers and their premature infants. © The Author(s) 2015.

  9. From PPROM to caul: The evolution of membrane rupture in mammals

    Directory of Open Access Journals (Sweden)

    Gregory Stempfle

    2013-12-01

    Full Text Available Rupture of the extraembryonic membranes that form the gestational sac in humans is a typical feature of human parturition. However, preterm premature rupture of membranes (PPROM occurs in approximately 1% of pregnancies, and is a leading cause of preterm birth. Conversely, retention of an intact gestational sac during parturition in the form of a caul is a rare occurrence. Understanding the molecular and evolutionary underpinnings of these disparate phenotypes can provide insight into both normal pregnancy and PPROM. Using phylogenetic techniques we reconstructed the evolution of the gestational sac phenotype at parturition in 55 mammal species representing all major viviparous mammal groups. We infer the ancestral state in therians, eutherians, and primates, as in humans, is a ruptured gestational sac at parturition. We present evidence that intact membranes at parturition have evolved convergently in diverse mammals including horses, elephants, and bats. In order to gain insight into the molecular underpinnings of the evolution of enhanced membrane integrity we also used comparative genomics techniques to reconstruct the evolution of a subset of genes implicated in PPROM, and find that four genes (ADAMTS2, COL1A1, COL5A1, LEPRE1 show significant evidence of increased nonsynonymous rates of substitution on lineages with intact membranes as compared to those with ruptured membranes. Among these genes, we also discovered that 17 human SNPs are associated with or near amino acid replacement sites in those mammals with intact membranes. These SNPs are candidate functional variants within humans, which may play roles in both PPROM and/or the retention of the gestational sac at birth.

  10. Ruptured venous aneurysm of cervicomedullary junction

    Directory of Open Access Journals (Sweden)

    Ashish Aggarwal

    2014-01-01

    Full Text Available Background: Ruptured venous aneurysm is often seen with arterio-venous malformation (AVM or developmental venous anomaly (DVA. However, isolated venous aneurysm is unusual. Case Description: We present a case of ruptured venous aneurysm that presented with subarachnoid hemorrhage (SAH and intraventricular hemorrhage (IVH. Digital substraction angiography (DSA revealed a saccular contrast filling pouch in the left lateral aspect of cervicomedullary junction (CMJ. Endovascular intervention was not a viable option. During surgery, a saccular pliable structure approx. 1.5 Χ 1 cm was found in the subarachnoid space that was clipped and excised. There were no arterial feeders, no evidence of surrounding AVM, and no dilated perimedullary vein. Conclusion: This is perhaps the first reported case of ruptured venous aneurysm (without associated AVM of CMJ, which was successfully managed surgically. The possible etiologies remain an unnoticed head trauma or a congenital vessel wall abnormality. Surgically clipping and excision remains the treatment of choice for such lesion.

  11. The Identity Process in Times of Ruptures

    DEFF Research Database (Denmark)

    Awad, Sarah H.

    2016-01-01

    revolution, at which time Egypt has witnessed major social and political changes. The aim is to understand the identity process of individuals as they develop and adapt through changing social contexts and how they create alternative social relations as they engage in prefigurative politics. The findings......This is a longitudinal study of the identity process through times of dramatic social change. Using a narrative psychological approach this research follows the life stories of five Egyptian bloggers as they write their stories on online blogs over the course of the three years following the 2011...... shed light on how ruptures trigger a process of reflexivity, adaptive learning, and sense-making that facilitates coping and the reconstruction of a positive identity after ruptures. It also suggests that the narration of the experience of rupture through storytelling creates a heightened sense...

  12. Right ventricular hydatid cyst ruptured to pericardium

    Directory of Open Access Journals (Sweden)

    Feridoun Sabzi

    2015-01-01

    Full Text Available Cardiac hydatidosis is rare presentation of body hydatidosis. Incidence of cardiac involvements range from 5% to 5% of patients with hydatid disease. Most common site of hydatid cyst in heart is interventricular septum and left ventricular free wall. Right ventricular free wall involvement by cyst that ruptured to pericardial cavity is very rare presentation of hydatid cyst. Cardiac involvement may have serious consequences such as rupture to blood steam or pericardial cavity. Both the disease and its surgical treatment carry a high complication rate, including rupture leading to cardiac tamponade, anaphylaxis and also death. In the present report, a 43-year-old man with constrictive pericarditis secondary to a pericardial hydatid cyst is described.

  13. The Identity Process in Times of Ruptures

    DEFF Research Database (Denmark)

    Awad, Sarah H.

    2016-01-01

    This is a longitudinal study of the identity process through times of dramatic social change. Using a narrative psychological approach this research follows the life stories of five Egyptian bloggers as they write their stories on online blogs over the course of the three years following the 2011...... revolution, at which time Egypt has witnessed major social and political changes. The aim is to understand the identity process of individuals as they develop and adapt through changing social contexts and how they create alternative social relations as they engage in prefigurative politics. The findings...... shed light on how ruptures trigger a process of reflexivity, adaptive learning, and sense-making that facilitates coping and the reconstruction of a positive identity after ruptures. It also suggests that the narration of the experience of rupture through storytelling creates a heightened sense...

  14. Creep rupture behavior of unidirectional advanced composites

    Science.gov (United States)

    Yeow, Y. T.

    1980-01-01

    A 'material modeling' methodology for predicting the creep rupture behavior of unidirectional advanced composites is proposed. In this approach the parameters (obtained from short-term tests) required to make the predictions are the three principal creep compliance master curves and their corresponding quasi-static strengths tested at room temperature (22 C). Using these parameters in conjunction with a failure criterion, creep rupture envelopes can be generated for any combination of in-plane loading conditions and ambient temperature. The analysis was validated experimentally for one composite system, the T300/934 graphite-epoxy system. This was done by performing short-term creep tests (to generate the principal creep compliance master curves with the time-temperature superposition principle) and relatively long-term creep rupture tensile tests of off-axis specimens at 180 C. Good to reasonable agreement between experimental and analytical results is observed.

  15. Rupture of pectoralis major muscle: review article

    Directory of Open Access Journals (Sweden)

    Guity MR

    2010-05-01

    Full Text Available "nBackground: Rupture of pectoralis major muscle is a very rare and often athletic injury. These days in our country this injury occurs more frequently. This could be due to increase in professional participation of amateur people in different types of sport, like body building and weight-lifting (especially bench-pressing without adequate preparation, training and taking necessary precautions. In this article, we have tried to review several aspects of complex anatomy of pectoralis major muscle, epidemiology, mechanism, clinical presentations, imaging modalities, surgical indications and techniques of its rupture. Complex and especial anatomy of pectoralis major muscle, in its humeral insertion particularly, have a major role of its vulnerability to sudden and eccentric contraction as the main mechanism of rupture. Also, restoration of this complex anatomy seems to be important during surgical repair to have normal function of the muscle again.

  16. Linguine sign in musculoskeletal imaging: calf silicone implant rupture

    Energy Technology Data Exchange (ETDEWEB)

    Duryea, Dennis; Petscavage-Thomas, Jonelle [Milton S. Hershey Medical Center, Department of Radiology, H066, 500 University Drive, P.O. Box 850, Hershey, PA (United States); Frauenhoffer, Elizabeth E. [Milton S. Hershey Medical Center, Department of Pathology, 500 University Drive, P.O. Box 850, Hershey, PA (United States); Walker, Eric A. [Milton S. Hershey Medical Center, Department of Radiology, H066, 500 University Drive, P.O. Box 850, Hershey, PA (United States); Uniformed Services University of the Health Sciences, Department of Radiology and Nuclear Medicine, Bethesda, MD, 20814 (United States)

    2015-08-15

    Imaging findings of breast silicone implant rupture are well described in the literature. On MRI, the linguine sign indicates intracapsular rupture, while the presence of silicone particles outside the fibrous capsule indicates extracapsular rupture. The linguine sign is described as the thin, wavy hypodense wall of the implant within the hyperintense silicone on T2-weighted images indicative of rupture of the implant within the naturally formed fibrous capsule. Hyperintense T2 signal outside of the fibrous capsule is indicative of an extracapsular rupture with silicone granuloma formation. We present a rare case of a patient with a silicone calf implant rupture and discuss the MRI findings associated with this condition. (orig.)

  17. Alterations in Functional Connectivity for Language in Prematurely Born Adolescents

    Science.gov (United States)

    Schafer, Robin J.; Lacadie, Cheryl; Vohr, Betty; Kesler, Shelli R.; Katz, Karol H.; Schneider, Karen C.; Pugh, Kenneth R.; Makuch, Robert W.; Reiss, Allan L.; Constable, R. Todd; Ment, Laura R.

    2009-01-01

    Recent data suggest recovery of language systems but persistent structural abnormalities in the prematurely born. We tested the hypothesis that subjects who were born prematurely develop alternative networks for processing language. Subjects who were born prematurely (n = 22; 600-1250 g birth weight), without neonatal brain injury on neonatal…

  18. 14 CFR 1214.806 - Premature termination of Spacelab flights.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Premature termination of Spacelab flights... FLIGHT Reimbursement for Spacelab Services § 1214.806 Premature termination of Spacelab flights. If a... are, in NASA's judgment, adversely affected by such premature termination. The basis for proration...

  19. A Rare Case of Simultaneous Acute Bilateral Quadriceps Tendon Rupture and Unilateral Achilles Tendon Rupture

    Directory of Open Access Journals (Sweden)

    Wei Yee Leong

    2013-07-01

    Full Text Available Introduction: There have been multiple reported cases of bilateral quadriceps tendon ruptures (QTR in the literature. These injuries frequently associated with delayed diagnosis, which results in delayed surgical treatment. In very unusual cases, bilateral QTRs can be associated with other simultaneous tendon ruptures. Case Report: We present a rare case of bilateral QTR with a simultaneous Achilles Tendon Rupture involving a 31 years old Caucasian man who is a semi-professional body builder taking anabolic steroids. To date bilateral QTR with additional TA rupture has only been reported once in the literature and to our knowledge this is the first reported case of bilateral QTR and simultaneous TA rupture in a young, fit and healthy individual. Conclusion: The diagnosis of bilateral QTR alone can sometimes be challenging and the possibility of even further tendon injuries should be carefully assessed. A delay in diagnosis could result in delay in treatment and potentially worse outcome for the patient. Keywords: Quadriceps tendon rupture; Achilles tendon rupture; Bilateral.

  20. Gravid med spontan ruptur af arteria uterina

    DEFF Research Database (Denmark)

    Jònsdòttir, Fjòla; Pinborg, Anja; Wilken-Jensen, Charlotte

    2014-01-01

    Pregnant women with acute abdominal pain are a clinical challenge. We present a rare but potential life-threatening condition of a pregnant woman with acute abdominal pain. The woman was in gestational week 37 with severe abdominal pain and was admitted to the labour ward. She became haemo......-dynamic instable 24 hours after vaginal delivery, and emergency laparotomi revealed a spontaneous rupture of the right uterine artery. Spontaneous rupture of the uterine artery is rare but should be considered as a possible cause of acute abdominal pain in pregnant women....

  1. Thoracic Outlet Syndrome Following Breast Implant Rupture

    Directory of Open Access Journals (Sweden)

    Raakhi Mistry, MBChB

    2015-03-01

    Full Text Available Summary: We present a patient with bilateral breast implant rupture who developed severe locoregional silicone granulomatous lymphadenopathy. Poly Implant Prothese silicone implants had been used for bilateral breast augmentation 5 years prior. Extracapsular implant rupture and bilateral axillary lymphadenopathy indicated explantation, capsulectomy, and selective lymph node excision. Histology demonstrated silicone lymphadenopathy with no evidence of malignancy. Over the subsequent 12 months, she developed progressive locoregional lymphadenopathy involving bilateral cervical, axillary, and internal mammary groups, resulting in bilateral thoracic outlet syndrome. We report the unusual presentation, progression, and the ultimate surgical management of this patient.

  2. Thoracic outlet syndrome following breast implant rupture.

    Science.gov (United States)

    Mistry, Raakhi; Caplash, Yugesh; Giri, Pratyush; Kearney, Daniel; Wagstaff, Marcus

    2015-03-01

    We present a patient with bilateral breast implant rupture who developed severe locoregional silicone granulomatous lymphadenopathy. Poly Implant Prothese silicone implants had been used for bilateral breast augmentation 5 years prior. Extracapsular implant rupture and bilateral axillary lymphadenopathy indicated explantation, capsulectomy, and selective lymph node excision. Histology demonstrated silicone lymphadenopathy with no evidence of malignancy. Over the subsequent 12 months, she developed progressive locoregional lymphadenopathy involving bilateral cervical, axillary, and internal mammary groups, resulting in bilateral thoracic outlet syndrome. We report the unusual presentation, progression, and the ultimate surgical management of this patient.

  3. ACHILLES TENDON RUPTURE AND PLATELET RICH PLASMA

    Directory of Open Access Journals (Sweden)

    Pietro Zedde

    2012-03-01

    Full Text Available Achilles tendon rupture is currently one of the most frequent injuries in athletes. Such rupture may be caused by a sudden dorsiflexion of the ankle, pushing off with the weight bearing forefoot while extending the knee or violent dorsiflexion of a plantar flexed foot. The treatment goal consists of restoring the normal tendon length and tension, as well as the function and strength of the gastrocnemius-soleus complex. The biological repair process can be enhanced in all stages of recovery with the use of PRP (Platelet Rich Plasma without any side effects.

  4. Rupture of the plantar fascia in athletes.

    Science.gov (United States)

    Leach, R; Jones, R; Silva, T

    1978-06-01

    Symptoms resembling those of plantar fasciitis were seen in six athletes who were thought to have a partial rupture of the plantar fascia. Treatment, which included the use of crutches, anti-inflammatory agents, strapping of the arch, and ice packs, was successful in all but one patient who had a painful mass in the area of the previous rupture. After surgical excision of the painful mass and release of the fascia, he recovered. Five of the six athletes had been previously treated with repeated local injections of steroid.

  5. POVRATAK SPORTSKIM AKTIVNOSTIMA POSLIJE RUPTURE AHILOVE TETIVE

    Directory of Open Access Journals (Sweden)

    Miroslav Kezunović

    2010-09-01

    Full Text Available One of the most important goals of the treatment of sports injuries is athletes’ early return to normal sporting activities. Time when the athletes will return to normal sporting activities, after Achilles tendon acute rupture, depends on the level of sports involvement. Average time of return to sport is usually between 5-6 months after rupture. Patients, who are treated using postoperative functional cast, can expect an average return to their sport a month earlier than those who after surgery used solid cast immobilization. The most important signs that indicate possible slow rehabilitation process are the pain and swelling after activity and late recovery of the tissue.

  6. Mycotic aneurysm rupture of the descending aorta

    Energy Technology Data Exchange (ETDEWEB)

    Gufler, H.; Buitrago-Tellez, C.H.; Nesbitt, E.; Hauenstein, K.H. [Department of Radiology, Albert-Ludwigs-Universitaet, Freiburg (Germany)

    1998-03-01

    A 69-year-old diabetic male with salmonella bacteremia developed hypovolemic shock and swelling of the neck. A CT examination revealed massive mediastinal hemorrhage extending into the neck soft tissues caused by false aneurysm rupture of the descending thoracic aorta. Aortography showed continuous extravasation from a large leak at the medial side of the descending thoracic aorta. Although surgical intervention was immediately performed, the patient died 3 weeks later from multiple-organ failure. In this report, CT and angiographic findings of mycotic aneurysm rupture are presented and a review is given. (orig.) With 2 figs., 11 refs.

  7. Prematurity: an overview and public health implications.

    Science.gov (United States)

    McCormick, Marie C; Litt, Jonathan S; Smith, Vincent C; Zupancic, John A F

    2011-01-01

    The high rate of premature births in the United States remains a public health concern. These infants experience substantial morbidity and mortality in the newborn period, which translate into significant medical costs. In early childhood, survivors are characterized by a variety of health problems, including motor delay and/or cerebral palsy, lower IQs, behavior problems, and respiratory illness, especially asthma. Many experience difficulty with school work, lower health-related quality of life, and family stress. Emerging information in adolescence and young adulthood paints a more optimistic picture, with persistence of many problems but with better adaptation and more positive expectations by the young adults. Few opportunities for prevention have been identified; therefore, public health approaches to prematurity include assurance of delivery in a facility capable of managing neonatal complications, quality improvement to minimize interinstitutional variations, early developmental support for such infants, and attention to related family health issues.

  8. The genetic basis of premature ovarian failure.

    Science.gov (United States)

    Woad, Kathryn J; Watkins, Wendy J; Prendergast, Deborah; Shelling, Andrew N

    2006-06-01

    Premature ovarian failure (POF) is a common condition, affecting approximately 1:100 women. It is characterised by amenorrhea, hypoestrogenism, and elevated gonadotrophin levels in women under the age of 40. It is often an unexpected and distressing diagnosis, which coincides with infertility and menopausal symptoms. There is a well recognised genetic basis to the development of POF. Our laboratory has identified several candidate genes associated with POF.

  9. Progeria: A rare genetic premature ageing disorder

    OpenAIRE

    Jitendra Kumar Sinha; Shampa Ghosh; Manchala Raghunath

    2014-01-01

    Progeria is characterized by clinical features that mimic premature ageing. Although the mutation responsible for this syndrome has been deciphered, the mechanism of its action remains elusive. Progeria research has gained momentum particularly in the last two decades because of the possibility of revealing evidences about the ageing process in normal and other pathophysiological conditions. Various experimental models, both in vivo and in vitro, have been developed in an effort to understand...

  10. The drug treatment of premature ejaculation

    OpenAIRE

    Hisasue, Shin-ichi

    2016-01-01

    The management recommendation for both acquired premature ejaculation (APE) and lifelong PE (LPE) are similar, such as a behavioral/psychotherapy, a pharmacotherapy and a combination of these treatments. For the drug treatment for PE, gold standard is selective serotonin reuptake inhibitors (SSRIs) including dapoxetine or paroxetine. The drug treatment for PE is still developing and some new promising therapeutic options have been proposed. Topical anesthetics, tramadol, and alpha-1 blockers ...

  11. Spontaneous Uterine Rupture during Pregnancy: Case Report and ...

    African Journals Online (AJOL)

    After ultrasound scan, uterine rupture was diagnosed and an emergency .... Uterine rupture in multiparity occurs usually during labour. We think that our patient may have had uterine scar from ... abdominal pains and signs of shock, at which.

  12. Source rupture process of the 2011 Fukushima-ken Hamadori earthquake: how did the two subparallel faults rupture?

    Science.gov (United States)

    Tanaka, Miho; Asano, Kimiyuki; Iwata, Tomotaka; Kubo, Hisahiko

    2014-12-01

    The 2011 Fukushima-ken Hamadori earthquake (MW 6.6) occurred about a month after the 2011 Great Tohoku earthquake (MW 9.0), and it is thought to have been induced by the 2011 Tohoku earthquake. After the 2011 Hamadori earthquake, two subparallel faults (the Itozawa and Yunodake faults) were identified by field surveys. The hypocenter was located nearby the Itozawa fault, and it is probable that the Itozawa fault ruptured before the Yunodake fault rupture. Here, we estimated the source rupture process of the 2011 Hamadori earthquake using a model with two subparallel faults based on strong motion data. The rupture starting point and rupture delay time of the Yunodake fault were determined based on Akaike's Bayesian Information Criterion (ABIC). The results show that the Yunodake fault started to rupture from the northern deep point 4.5 s after the Itozawa fault started to rupture. The estimated slip distribution in the shallow part is consistent with the surface slip distribution identified by field surveys. Time-dependent Coulomb failure function changes (ΔCFF) were calculated using the stress change from the Itozawa fault rupture in order to evaluate the effect of the rupture on the Yunodake fault. The ΔCFF is positive at the rupture starting point of the Yunodake fault 4.5 s after the Itozawa fault started to rupture; therefore, it is concluded that during the 2011 Hamadori earthquake, the Yunodake fault rupture was triggered by the Itozawa fault rupture.

  13. Bilateral synchronous rupture of the quadriceps tendon.

    LENUS (Irish Health Repository)

    Ellanti, P

    2012-09-01

    Bilateral simultaneous rupture of the quadriceps tendon is a rare entity. They are often associated with degenerative changes of the tendons and predisposing conditions such as diabetes or excessive steroid use. They most commonly tend to occur in patients of 40 years of age or older.

  14. The electrocardiogram in traumatic right atrial rupture

    NARCIS (Netherlands)

    van Veldhuisen, DJ; van den Berg, MP

    1999-01-01

    We:report the case of a previously healthy 20-year-old man who had a traumatic rupture of the right atrium. On admission an electrocardiogram (ECG) was recorded which is highly remarkable and, retrospectively, suggestive for the diagnosis. The patient died soon after the EGG, and the diagnosis was m

  15. TREATMENT OF OLD ACHILLES TENDON RUPTURES

    Directory of Open Access Journals (Sweden)

    N. A. Koryshkov

    2012-01-01

    Full Text Available From 1998 to 2010 32 patients (14 men, 18 women, aged 15-65 years, underwent surgical treatment for old Achilles tendon rupture. In all cases correct diagnosis was made not earlier than 1 month after injury. The importance of clinical Thompson test and sonographic examination for diagnosis of Achilles tendon rupture is underlined. For the restoration of Achilles tendon V-Y plasty was used. Surgery was performed in a period of 1 to 13 months in patients with subcutaneous Achilles tendon ruptures. Follow-up results of patients in the postoperative period ranged from 6 months to 10 years (mean follow-up 1 year 7 months. Date of observation in the postoperative period ranged from 6 months to 19 years. Marginal necrosis wound occurred in 3 (10% patients, re-rupture of the Achilles tendon to tendon suture zone - in one patient, even in one patient on day 14 became infected. Violations of the foot innervation were no detected.

  16. Plantar fascia rupture associated with corticosteroid injection.

    Science.gov (United States)

    Sellman, J R

    1994-07-01

    A series of 37 patients, all with a presumptive diagnosis of plantar fascia rupture, is presented. All had had prior heel pain diagnosed as plantar fasciitis, and all had been treated with corticosteroid injection into the calcaneal origin of the fascia. One third described a sudden tearing episode in the heel, while the rest had a gradual change in symptoms. Most of the patients had relief of the original heel pain, which had been replaced by a variety of new foot problems, including dorsal and lateral midfoot pain, swelling, foot weakness, metatarsal pain, and metatarsal fracture. In all 37 patients, there was a palpable diminution in the tension of the plantar fascia on the involved side, and footprints often showed a flattening of the involved arch. Magnetic resonance imaging done on one patient showed attenuation of the plantar fascia. From these observations and data, the author concluded that plantar fascia rupture had occurred. Treatment following rupture included supportive shoes, orthoses, and time. The majority had resolution of their new symptoms, but this often took 6 to 12 months to occur. In the remainder, there were persisting symptoms. Corticosteroid injections, although helpful in the treatment of plantar fasciitis, appear to predispose to plantar fascia rupture.

  17. Muscle rupture associated with statin use

    NARCIS (Netherlands)

    Ekhart, C.; Jong, L.A.W.; Gross-Martirosyan, L.; Hunsel, F. van

    2016-01-01

    AIM: Statins are used in the treatment of hyperlipidaemia. They are among the most commonly prescribed drugs worldwide. Statins have been linked to musculoskeletal adverse drug reactions. However muscle rupture has not been discussed as an adverse drug reaction to statins so far. The aim of this

  18. Case report: Traumatic unilateral testicular rupture

    Directory of Open Access Journals (Sweden)

    Natasha J.G. Bauer

    2016-01-01

    Conclusion: Emergency assessment and diagnosis as well as scrotal exploration are important components of the management of acute testicular rupture. Analysis of the literature proves that timely surgical intervention is crucial; early intervention results in higher rates of preservation and avoids the need for an orchidectomy.

  19. Diagnosis and management of testicular ruptures.

    Science.gov (United States)

    Buckley, Jill C; McAninch, Jack W

    2006-02-01

    Testicular ruptures are a common occurrence in scrotal trauma that can go undetected ifa thorough examination or scrotal ultrasonography is not performed. Timely operative exploration and reconstruction is the standard of care and leads to high testicular salvage rates with hormonal, reproductive, and cosmetic benefits for the patient.

  20. Fatigue crack propagation analysis of plaque rupture.

    Science.gov (United States)

    Pei, Xuan; Wu, Baijian; Li, Zhi-Yong

    2013-10-01

    Rupture of atheromatous plaque is the major cause of stroke or heart attack. Considering that the cardiovascular system is a classic fatigue environment, plaque rupture was treated as a chronic fatigue crack growth process in this study. Fracture mechanics theory was introduced to describe the stress status at the crack tip and Paris' law was used to calculate the crack growth rate. The effect of anatomical variation of an idealized plaque cross-section model was investigated. The crack initiation was considered to be either at the maximum circumferential stress location or at any other possible locations around the lumen. Although the crack automatically initialized at the maximum circumferential stress location usually propagated faster than others, it was not necessarily the most critical location where the fatigue life reached its minimum. We found that the fatigue life was minimum for cracks initialized in the following three regions: the midcap zone, the shoulder zone, and the backside zone. The anatomical variation has a significant influence on the fatigue life. Either a decrease in cap thickness or an increase in lipid pool size resulted in a significant decrease in fatigue life. Comparing to the previously used stress analysis, this fatigue model provides some possible explanations of plaque rupture at a low stress level in a pulsatile cardiovascular environment, and the method proposed here may be useful for further investigation of the mechanism of plaque rupture based on in vivo patient data.

  1. Surgical management of spontaneous ruptured hepatocellular adenoma

    Directory of Open Access Journals (Sweden)

    Marcelo Augusto Fontenelle Ribeiro Junior

    2009-01-01

    Full Text Available AIMS: Spontaneous ruptured hepatocellular adenoma (SRHA is a rare life-threatening condition that may require surgical treatment to control hemorrhaging and also stabilize the patient. We report a series of emergency surgeries performed at our institution for this condition. METHODS: We reviewed medical records and radiology files of 28 patients (from 1989 to 2006 with a proven diagnosis of hepatocellular adenoma (HA. Three (10.7% of 28 patients had spontaneous ruptured hepatocellular adenoma, two of which were associated with intrahepatic hemorrhage while one had intraperitoneal bleeding. Two patients were female and one was male. Both female patients had a background history of oral contraceptive use. Sudden abdominal pain associated with hemodynamic instability occurred in all patients who suffered from spontaneous ruptured hepatocellular adenoma. The mean age was 41.6 years old. The preoperative assessment included liver function tests, ultrasonography and computed tomography. RESULTS: The surgical approaches were as follows: right hemihepatectomy for controlling intraperitoneal bleeding, and right extended hepatectomy and non-anatomic resection of the liver for intrahepatic hemorrhage. There were no deaths, and the postoperative complications were bile leakage and wound infection (re-operation, as well as intraperitoneal abscess (re-operation and pleural effusion. CONCLUSION: Spontaneous ruptured hepatocellular adenoma may be treated by surgery for controlling hemorrhages and stabilizing the patient, and the decision to operate depends upon both the patient's condition and the expertise of the surgical team.

  2. [Simultaneous rupture of a patellar tendon and contralateral quadriceps tendon].

    Science.gov (United States)

    Horas, U; Ernst, S; Meyer, C; Halbsguth, A; Herbst, U

    2006-09-01

    The simultaneous bilateral rupture of the quadriceps tendon is a rare injury; only occasional reports exist about the bilateral simultaneous rupture of the patellar tendon. Degenerative changes of the tendon due to drugs or diseases lead to the rupture. We describe two cases of simultaneous rupture of the patellar and contralateral quadriceps tendons; only one patient had special risks. We report the management of therapy and the functional results using the Lysholm score and Knee Rating Scale.

  3. [Prematurity risk according to prematurity risk score and postpartal morbidity of the newborn infants (author's transl)].

    Science.gov (United States)

    Coradello, H; Lubec, G; Simbruner, G

    1981-02-01

    Risk of premature birth was evaluated retrospectively in 610 women in the first days after delivery using the prematurity risk score published by Thalhammer 1973. The calculated risk of premature birth was compared than prospectively to postpartal morbidity of the newborn infants as determined by duration of hospital stay, incidence of respiratory distress syndrome, need of artificial ventilation and mortality. A positive correlation could be found between risk of premature birth and postpartal morbidity of the newborn infants especially in small premature infants with birthweights of 2000 grams and less. The same correlation existed also in two groups of infants out of two different obstetric clinics which showed the same distribution of prenatal risks and the same prenatal care frequencies. It clearly becomes evident that infants with the same prenatal risks but good prenatal care during pregnancy had much lower hospital stays, lower respiratory distress frequencies and lower mortality rates than babies delivered from pregnancies badly cared for. These prenatal care related differences in postpartum morbidity again were much more evident in infants out of lower birth weight classes.

  4. A case of splenic torsion and rupture presenting as ruptured ectopic pregnancy

    Directory of Open Access Journals (Sweden)

    Somdatta Lahiri

    2010-12-01

    Full Text Available Splenic torsion with rupture of spleen is an extremely rare phenomenon. The clinical picture mimics several common conditions which are causes of acute abdomen and so it is seldom detected pre-operatively. An 18 year old female patient was admitted with an acute abdomen and shock. The provisional diagnosis was of a ruptured ectopic pregnancy. Peri-operatively we found a spontaneous rupture of the spleen following torsion along with early intrauterine pregnancy. Splenectomy was carried out and patient recovered well. Our report confirms that this rare entity can present as an acute abdomen which is very difficult to diagnose preoperatively and can masquerade as ruptured ectopic pregnancy in women of childbearing age group.

  5. Challenging Friesian horse diseases : aortic rupture and megaesophagus

    NARCIS (Netherlands)

    Ploeg, M.

    2015-01-01

    Aortic rupture is quite rare in Warmblood horses and is best known as an acute and fatal rupture of the aortic root in older breeding stallions. It has now become clear that aortic rupture, which is diagnosed around an age of 4 years, is more frequent in the Friesian breed than in others. The high p

  6. Bilateral spontaneous rupture of flexor digitorum profundus tendons.

    LENUS (Irish Health Repository)

    O'Sullivan, S T

    2012-02-03

    Spontaneous tendon rupture is an unusual condition usually associated with underlying disease processes such as rheumatoid arthritis, chronic renal failure or bony abnormalities of the hand. We report a case of spontaneous, non-concurrent bilateral rupture of flexor profundus tendons in an otherwise healthy individual. Treatment was successful and consisted of a two-stage reconstruction of the ruptured tendon.

  7. Investigation of Creep Rupture Phenomenon in Glass Fibre Reinforced Polymer (GFRP) Stirrups

    Science.gov (United States)

    Johal, Kanwardeep Singh

    Glass Fibre-Reinforced Polymer (GFRP) bars offer a feasible alternative to typical steel reinforcement in concrete structures where there are concerns of corrosion or magnetic interference. In order to design safe structures for a service life of 50 to 100 years, the long-term material properties of GFRP must be understood. Thirty GFRP stirrups of three types were tested under sustained loading to investigate creep rupture and modulus degradation behaviour. The time to failure under varying sustained loads was used to extrapolate the safe design load for typical service lives. It was found that shear critical beams with shear reinforcement designed in accordance with CSA-S806 and ACI-440 provisions may be at risk of premature failure under sustained design loads. Analysis was based on finite element modelling and previously tested beams. Additionally, no moduli degradation was observed in this study. A cumulative weakening model was developed to potentially take into account fatigue loading.

  8. Retinopathy of prematurity outcome in infants with Prethreshold Retinopathy of Prematurity and oxygen saturation > 94% in room air : The High Oxygen Percentage in Retinopathy of Prematurity study

    NARCIS (Netherlands)

    McGregor, ML; Bremer, DL; Cole, C; McClead, RE; Phelps, DL; Fellows, RR; Oden, N

    2002-01-01

    Objectives. To determine the rate of progression from prethreshold to threshold retinopathy of prematurity (ROP) in infants excluded from Supplemental Therapeutic Oxygen for Prethreshold Retinopathy of Prematurity (STOP-ROP) because their median arterial oxygen saturation by pulse oximetry (Spo(2))

  9. Predicting lung maturity in preterm rupture of membranes via lamellar bodies count from a vaginal pool: a cohort study

    Directory of Open Access Journals (Sweden)

    Nachum Zohar

    2009-10-01

    Full Text Available Abstract Background Amniocentesis is the accepted mode of attaining amniotic fluid to perform tests for fetal lung maturity. The purpose of this study was to validate a non-invasive fetal lung maturity test by counting lamellar bodies from a vaginal pool among women with preterm premature rupture of membranes. Methods In a prospective study, amniotic fluid specimens were collected from a vaginal pool from women after preterm premature rupture of membranes with gestational age between 27 and 36 completed weeks. Receiver operating characteristics curve was estimated to assess the threshold of lamellar bodies' count that may predict fetal lung maturity. Results Seventy-five specimens were collected of which 17 were between 32 to 34 weeks. A lamellar bodies' count of 28,000 or more predicted mature fetus 100% of the time (specificity among all women and also among women between 32 to 34 weeks. The sensitivity was 72% among all and 92% when gestational age was between 32 to 34 weeks. A count of 8,000 or less, predicted respiratory distress syndrome with a sensitivity of 98% among the whole group. Conclusion Counting of lamellar bodies in amniotic fluid from a vaginal pool may be used to predict fetal lung maturity.

  10. Premature menopause linked to CVD and osteoporosis.

    Science.gov (United States)

    Park, Claire; Overton, Caroline

    2010-03-01

    Premature menopause affects 1% of women under the age of 40, the usual age of the menopause is 51. Most women will present with irregular periods or no periods at all with or without climacteric symptoms. Around 10% of women present with primary amenorrhoea. A careful history and examination are required. It is important to ask specifically about previous chemotherapy or radiotherapy and to look for signs of androgen excess e.g. polycystic ovarian syndrome, adrenal problems e.g. galactorrhoea and thyroid goitres. Once pregnancy has been excluded, a progestagen challenge test can be performed in primary care. Norethisterone 5 mg tds po for ten days or alternatively medroxyprogesterone acetate 10 mg daily for ten days is prescribed. A withdrawal bleed within a few days of stopping the norethisterone indicates the presence of oestrogen and bleeding more than a few drops is considered a positive withdrawal bleed. The absence of a bleed indicates low levels of oestrogen, putting the woman at risk of CVD and osteoporosis. FSH levels above 30 IU/l are an indicator that the ovaries are failing and the menopause is approaching or has occurred. It should be remembered that FSH levels fluctuate during the month and from one month to the next, so a minimum of two measurements should be made at least four to six weeks apart. The presence of a bleed should not exclude premature menopause as part of the differential diagnosis as there can be varying and unpredictable ovarian function remaining. The progestagen challenge test should not be used alone, but in conjunction with FSH, LH and oestradiol. There is no treatment for premature menopause. Women desiring pregnancy should be referred to a fertility clinic and discussion of egg donation. Women not wishing to become pregnant should be prescribed HRT until the age of 50 to control symptoms of oestrogen deficiency and reduce the risks of osteoporosis and CVD.

  11. The pathophysiology of lifelong premature ejaculation.

    Science.gov (United States)

    Waldinger, Marcel D

    2016-08-01

    For many decades it has been thought that lifelong premature ejaculation (PE) is only characterized by persistent early ejaculations. Despite enormous progress of in vivo animal research, and neurobiological, genetic and pharmacological research in men with lifelong PE, our current understanding of the mechanisms behind early ejaculations is far from complete. The new classification of PE into four PE subtypes has shown that the symptomatology of lifelong PE strongly differs from acquired PE, subjective PE and variable PE. The phenotype of lifelong PE and therefore also the pathophysiology of lifelong PE is much more complex. A substantial number of men with lifelong PE not only have PE, but also premature erection and premature penile detumescence as part of an acute hypertonic or hypererotic state when engaged in an erotic situation or when making love. As both erectio praecox, ejaculatio praecox, detumescentia praecox, and the hypererotic state are part of the phenotype lifelong PE, it is argued that lifelong PE is not only a disturbance of the timing of ejaculation but also a disturbance of the timing of erection, detumescence and arousal. Since 1998, the pathophysiology of lifelong PE was thought to be mainly mediated by the central serotonergic system in line with genetic polymorphisms of specific serotonergic genes. However, by accepting that lifelong PE is characterized by the reversible hypertonic state the hypothesis of mainly serotonergic dysfunction is no longer tenable. Instead, it has been postulated that the pathophysiology of lifelong PE is mediated by a very complex interplay of central and peripheral serotonergic, dopaminergic, oxytocinergic, endocrinological, genetic and probably also epigenetic factors. Progress in research of lifelong PE can only be accomplished when a stopwatch is used to measure the IELT and the cut-off point of 1 minute for the definition of lifelong PE is maintained. Current use of validated questionnaires, neglect of

  12. The pathophysiology of lifelong premature ejaculation

    Science.gov (United States)

    2016-01-01

    For many decades it has been thought that lifelong premature ejaculation (PE) is only characterized by persistent early ejaculations. Despite enormous progress of in vivo animal research, and neurobiological, genetic and pharmacological research in men with lifelong PE, our current understanding of the mechanisms behind early ejaculations is far from complete. The new classification of PE into four PE subtypes has shown that the symptomatology of lifelong PE strongly differs from acquired PE, subjective PE and variable PE. The phenotype of lifelong PE and therefore also the pathophysiology of lifelong PE is much more complex. A substantial number of men with lifelong PE not only have PE, but also premature erection and premature penile detumescence as part of an acute hypertonic or hypererotic state when engaged in an erotic situation or when making love. As both erectio praecox, ejaculatio praecox, detumescentia praecox, and the hypererotic state are part of the phenotype lifelong PE, it is argued that lifelong PE is not only a disturbance of the timing of ejaculation but also a disturbance of the timing of erection, detumescence and arousal. Since 1998, the pathophysiology of lifelong PE was thought to be mainly mediated by the central serotonergic system in line with genetic polymorphisms of specific serotonergic genes. However, by accepting that lifelong PE is characterized by the reversible hypertonic state the hypothesis of mainly serotonergic dysfunction is no longer tenable. Instead, it has been postulated that the pathophysiology of lifelong PE is mediated by a very complex interplay of central and peripheral serotonergic, dopaminergic, oxytocinergic, endocrinological, genetic and probably also epigenetic factors. Progress in research of lifelong PE can only be accomplished when a stopwatch is used to measure the IELT and the cut-off point of 1 minute for the definition of lifelong PE is maintained. Current use of validated questionnaires, neglect of

  13. A clinical analysis on 268 cases with premature birth%268例早产临床分析

    Institute of Scientific and Technical Information of China (English)

    邵莉萍; 陈友国; 杨纪实

    2012-01-01

    目的 探讨早产的相关因素及高危因素.方法 回顾性分析268例早产产妇(早产组)临床资料,并随机抽样等量足月产妇资料(对照组),比较两组孕产史、产前检查以及孕妇的产科合并症等危险因素.结果 早产组有人工流产史者124例(46.2%),人工流产≥2次者60例(22.4%),均明显多于对照组的99例(36.9%)和30例(11.2%)(P<0.05).早产组规则产前检查者148例(55.2%),明显低于对照组的196例(73.1%)(P<0.05).胎膜早破、子痫前期、多胎、胎位不正等为导致早产的高危因素.结论 早产是多因素作用的结果;应注重产前检查,加强围生期保健,降低早产的发生率.%Objective To investigate the factors and high risk factors for premature birth. Methods Data of 268 patients (group A) with premature birth were analyzed. Another 268 full-term parturients (group B) in the same period were randomly selected as the controls. The risk factors such as gestation and birth, antenatal care and complications of pregnancy were compared between two groups. Results The number of induced abortion and without regular routine prenatal tests were the premature birth-related factors. There were 124 cases(46. 2%) with a histry of induced abortion, of whom 60 cases(22. 4%) underwent induced abortion for ≥ twice in group A. There were 99 cases (36. 9%) with a histry of induced abortion,of whom 30 cases(11. 2%) underwent induced abortion for≥ twice in group B. The differences were significant between two groups(P<0. 05). The high risk factors for premature birth were preterm premature rupture of membrane, preeclampsia, multiple pregnancy and abnormal position of fetus. Conclusion Premature birth is caused by many factors. Attention should be paid to the prepartal examination and perinatal care for reducing the rate of premature birth.

  14. The drug treatment of premature ejaculation.

    Science.gov (United States)

    Hisasue, Shin-Ichi

    2016-08-01

    The management recommendation for both acquired premature ejaculation (APE) and lifelong PE (LPE) are similar, such as a behavioral/psychotherapy, a pharmacotherapy and a combination of these treatments. For the drug treatment for PE, gold standard is selective serotonin reuptake inhibitors (SSRIs) including dapoxetine or paroxetine. The drug treatment for PE is still developing and some new promising therapeutic options have been proposed. Topical anesthetics, tramadol, and alpha-1 blockers will be the next strategies of the drug treatment for PE in the future.

  15. Premature ejaculation: current and future treatments

    Institute of Scientific and Technical Information of China (English)

    Levent Gurkan; Matthew Oommen; Wayne J. G. Hellstrom

    2008-01-01

    Premature ejaculation (PE) is recognized to be the most common male sexual disorder. PE provides difficulties for professionals who treat this condition because there is neither a universally accepted definition nor a medication approved by the Food and Drug Administration (FDA). Despite these shortcomings, physicians continue to diagnose their patients with PE according to major guidelines and treat them with either behavioral therapies or off-label medications. This review focuses on current and emerging treatment options and medications for PE. Advantages and limitations of each treatment option are discussed in the light of current published peer-reviewed literature.

  16. Brittle dynamic damage due to earthquake rupture

    Science.gov (United States)

    Bhat, Harsha; Thomas, Marion

    2016-04-01

    The micromechanical damage mechanics formulated by Ashby and Sammis, 1990, and generalized by Deshpande and Evans 2008 has been extended to allow for a more generalized stress state and to incorporate an experimentally motivated new crack growth (damage evolution) law that is valid over a wide range of loading rates. This law is sensitive to both the crack tip stress field and its time derivative. Incorporating this feature produces additional strain-rate sensitivity in the constitutive response. The model is also experimentally verified by predicting the failure strength of Dionysus-Pentelicon marble over wide range of strain rates. We then implement this constitutive response to understand the role of dynamic brittle off-fault damage on earthquake ruptures. We show that off-fault damage plays an important role in asymmetry of rupture propagation and is a source of high-frequency ground motion in the near source region.

  17. Liquid salt environment stress-rupture testing

    Science.gov (United States)

    Ren, Weiju; Holcomb, David E.; Muralidharan, Govindarajan; Wilson, Dane F.

    2016-03-22

    Disclosed herein are systems, devices and methods for stress-rupture testing selected materials within a high-temperature liquid salt environment. Exemplary testing systems include a load train for holding a test specimen within a heated inert gas vessel. A thermal break included in the load train can thermally insulate a load cell positioned along the load train within the inert gas vessel. The test specimen can include a cylindrical gage portion having an internal void filled with a molten salt during stress-rupture testing. The gage portion can have an inner surface area to volume ratio of greater than 20 to maximize the corrosive effect of the molten salt on the specimen material during testing. Also disclosed are methods of making a salt ingot for placement within the test specimen.

  18. Ruptured Pebbles - a coseismic and paleoseismic indicator?

    Science.gov (United States)

    Weismüller, Christopher; Reicherter, Klaus

    2017-04-01

    To increase the understanding of paleo-earthquakes and deformation patterns, and the propagation of surface waves in the proximity of active faults, we use the mainly disregarded features of ruptured or broken pebbles within in a clayey matrix. Deformation of unconsolidated sediments (alluvium, colluvium) due to earthquake ruptures is a long investigated topic, including the degradation of the fault scarp. However, during many trenching studies aligned pebbles along the fault planes have been described, and attributed to coseismic deformation. Over the last decades, we have found many ruptured pebbles in trenches at active faults with historic earthquakes, but also aligned (rotated?) pebbles. Here, we describe ruptured pebbles from a Pleistocene debris flow near the coastline between the towns Carboneras and Mojácar (SE Spain), East of the Sierra Cabrera. The outcrop is on-fault at the transition of the active Carboneras and Palomares faults (major historical earthquakes with M 7 in 1518 and 1522), implying proximity to the earthquakes epicenters. The Carboneras (NE-SW), Gafarillos (E-W) and Palomares (NNE-SSW) faults form major faults in eastern Andalucia. The outcrop contains ruptured pebbles in an only slightly consolidated, Pleistocene debris flow with 50 % matrix content. Similar near-fault ruptured pebbles have already been observed in the Carrizales quarry near Baelo Claudia, S Spain, and many other sites (e.g., Italy, Greece, Russia), but always in the proximity of active faults. We measured the fractures of 100 pebbles as planes, if possible, or trend, in case no measureable plane was accessible. Complementary 3D-models of the outcrop and each ruptured pebble were created using Structure from Motion, allowing us to further study the pebbles morphology and geometry. Mode II and conjugate fractures are prevailing in the pebbles and the lack of surface-loading such as striations and dissolution pits neglects clast-interaction. Un-cemented shear planes

  19. [Conservative functional treatment of Achilles tendon ruptures].

    Science.gov (United States)

    Hüfner, T; Gaulke, R; Imrecke, J; Krettek, C; Stübig, T

    2010-09-01

    The conservative functional treatment of Achilles tendon ruptures has developed further over the last 20 years and is basically possible for 60-80% of patients. The treatment leads to success if the indications obtained by dynamic sonography are correctly interpreted (adaptation of the tendon ends up to 20 degrees plantar flexion), if the patient presents sufficient compliance and the physiotherapy is increasingly intensified depending on tendon healing. Modern ortheses allow an increased equinus position and therefore improved protection of the healing tendon. If these factors are present a relatively low re-rupture rate of only 7% can be achieved. The decisive advantage of conservative functional therapy is the avoidance of specific operative risks, such as infection and injury to the sural nerve. After removal of the orthesis the tendon should continue to be modeled using shoe insoles and raised heels.

  20. RARE PRESENTATION OF RUPTURED RUDIMENTARY HORN PREGNANCY

    Directory of Open Access Journals (Sweden)

    Shergill Harbhajan K, Grover Suparna, Chhabra Ajay

    2015-10-01

    Full Text Available It is a rare occurrence for the rudimentary horn of uterus to harbour a pregnancy and the usual outcome is devastating leading to a spontaneous rupture in second trimester with the patient presenting in shock with massive intra-peritoneal haemorrhage and if appropriate management is not instituted in time it may lead to high rate of mortality. We report an unusual case of rupture rudimentary horn pregnancy who presented as a chronic ectopic with an adnexal mass and surprisingly with no sign of shock. Diagnosis is often difficult in such a situation which puts the treating gynaecologist in dilemma. High clinical suspicion supplemented with radiological findings helped clinch the diagnosis and laparotomy was performed followed by resection of the rudimentary horn to prevent future complications.

  1. Plaque rupture in humans and mice

    DEFF Research Database (Denmark)

    Schwartz, Stephen M; Galis, Zorina S; Rosenfeld, Michael E

    2007-01-01

    Despite the many studies of murine atherosclerosis, we do not yet know the relevance of the natural history of this model to the final events precipitated by plaque disruption of human atherosclerotic lesions. The literature has become particularly confused because of the common use of terms...... such as "instability", "vulnerable", "rupture", or even "thrombosis" for features of plaques in murine model systems not yet shown to rupture spontaneously and in an animal surprisingly resistant to formation of thrombi at sites of atherosclerosis. We suggest that use of conclusory terms like "vulnerable" and "stable...... that various forms of data have implicated in plaque progression. For example, formation of the fibrous cap, protease activation, and cell death in the necrotic core can be well described and have all been modeled in well-defined experiments. The relevance of such well-defined, objective, descriptive...

  2. Case report: rupture of popliteal artery aneurysm

    Directory of Open Access Journals (Sweden)

    Altino Ono Moraes

    2015-06-01

    Full Text Available An 83-year-old female patient with a history of prior endovascular treatment to repair an abdominal aortic aneurysm presented with intense pain and edema in the left leg, with hyperemia and localized temperature increase. Doppler ultrasonography revealed a voluminous aneurysm of the popliteal artery with a contained rupture, and hematoma involving the popliteal fossa and the medial and anterior surfaces of the knee causing compression of the popliteal vein. Endovascular repair was accomplished with covered stents and the rupture was confirmed. during the procedure The aneurysm was excluded and the signs and symptoms it had caused resolved completely, but during the postoperative period the patient developed sepsis of pulmonary origin and died.

  3. [Application of massage therapy in premature infant nursing care].

    Science.gov (United States)

    Chang, Shu-Min; Sung, Huei-Chuan

    2007-02-01

    Massage therapy has been used in the care of premature infants for many years in western countries, and a significant body of research has already shown the effectiveness of massage therapy in significantly increasing body weight, decreasing infant hospital durations, enhancing bone formation, and improving behavior. Key considerations when applying massage therapy on premature infants include gestational age, bodyweight, and physical condition. Nurses can teach parents to administer massage therapy on their premature infants to enhance parent-child attachment and interaction. This article introduces massage therapy principles and methods, the effectiveness of massage therapy in premature infant care, and an approach to teaching parents how to apply massage therapy on their premature infants. Massage therapy can be included in premature infant care programs in the future.

  4. [Developmental change in facial recognition by premature infants during infancy].

    Science.gov (United States)

    Konishi, Yukihiko; Kusaka, Takashi; Nishida, Tomoko; Isobe, Kenichi; Itoh, Susumu

    2014-09-01

    Premature infants are thought to be at increased risk for developmental disorders. We evaluated facial recognition by premature infants during early infancy, as this ability has been reported to be impaired commonly in developmentally disabled children. In premature infants and full-term infants at the age of 4 months (4 corrected months for premature infants), visual behaviors while performing facial recognition tasks were determined and analyzed using an eye-tracking system (Tobii T60 manufactured by Tobii Technologics, Sweden). Both types of infants had a preference towards normal facial expressions; however, no preference towards the upper face was observed in premature infants. Our study suggests that facial recognition ability in premature infants may develop differently from that in full-term infants.

  5. Achilles tendon rupture; assessment of nonoperative treatment.

    Science.gov (United States)

    Barfod, Kristoffer Weisskirchner

    2014-04-01

    Acute Achilles tendon rupture is a frequent and potentially disabling injury. Over the past decade a change in treatment of acute Achilles tendon rupture away from operative towards non-operative treatment has taken place. However, the optimal non-operative treatment protocol remains to be clarified, particularly the role of weight-bearing during early rehabilitation. Also, there is a need for a clinically applicable and accurate measurement to detect patients in risk of developing Achilles tendon elongation. The aim of this PhD thesis was to evaluate non-operative treatment of acute Achilles tendon rupture. In study I, a cross-sectional survey was performed investigating the chosen treatment protocols across Scandinavia. In study II, the effect of immediate weight-bearing on patient reported and functional outcomes was investigated in a randomized controlled trial (RCT). In study III, the effect of immediate weight-bearing on the biomechanical properties of the plantar flexor muscle-tendon complex was investigated in an RCT. In study IV, validity, reliability and agreement of a novel ultrasound measurement of Achilles tendon length and elongation was tested. Study I found surgery to be the preferred treatment in 83% of departments in Denmark, 92% in Norway, 65% in Sweden, and 30% in Finland (p tendon complex. Study IV showed excellent intra-rater reliability (ICC 0.96, SEM 3.7 mm and MDC 10.3 mm), inter-rater reliability (ICC 0.97, SEM 3.3 mm and MDC 9.3 mm) and validity (measurement error 2%). Treatment algorithms across Scandinavia showed considerable variation, though operative treatment and controlled early weight-bearing was the preferred treatment in Denmark, Norway and Sweden. Immediate weight-bearing was found to be safe and recommendable in non-operative treatment of acute Achilles tendon rupture. The novel ultrasound measurement showed excellent reliability and acceptable validity and agreement.

  6. Spontaneous rupture of the plantar fascia.

    Science.gov (United States)

    Ahstrom, J P

    1988-01-01

    In this study, rupture of the plantar fascia was seen in five feet, of which four had had plantar fasciitis. At the time of the injury, which is an acceleration type of motion, there is severe pain in the heel followed by the development of ecchymosis in the sole and toward the heel of the foot. With conservative symptomatic care, the acute symptoms as well as the plantar fasciitis symptoms subside, generally allowing full activity in 3 to 4 weeks.

  7. Spontaneous bladder rupture in acute alcohol intoxication

    Directory of Open Access Journals (Sweden)

    Bahjat Barakat

    2014-03-01

    Full Text Available Spontaneous bladder rupture is a rare condition that can be followed by an acute alcohol intoxication and can be associated with significant morbidity and mortality. We report a case diagnosed in a alcoholic young male who was admitted to our emergency room for epigastric pain. The case demonstrates the difficulties with diagnosis and the need for physicians who work in an emergency room to be aware of this condition.

  8. Fan-structure waves in shear ruptures

    Science.gov (United States)

    Tarasov, Boris

    2016-04-01

    This presentation introduces a recently identified shear rupture mechanism providing a paradoxical feature of hard rocks - the possibility of shear rupture propagation through the highly confined intact rock mass at shear stress levels significantly less than frictional strength. According to the fan-mechanism the shear rupture propagation is associated with consecutive creation of small slabs in the fracture tip which, due to rotation caused by shear displacement of the fracture interfaces, form a fan-structure representing the fracture head. The fan-head combines such unique features as: extremely low shear resistance (below the frictional strength), self-sustaining stress intensification in the rupture tip (providing easy formation of new slabs), and self-unbalancing conditions in the fan-head (making the failure process inevitably spontaneous and violent). An important feature of the fan-mechanism is the fact that for the initial formation of the fan-structure an enhanced local shear stress is required, however, after completion of the fan-structure it can propagate as a dynamic wave through intact rock mass at shear stresses below the frictional strength. Paradoxically low shear strength of pristine rocks provided by the fan-mechanism determines the correspondingly low transient strength of the lithosphere, which favours generation of new earthquake faults in the intact rock mass adjoining pre-existing faults in preference to frictional stick-slip instability along these faults. The new approach reveals an alternative role of pre-existing faults in earthquake activity: they represent local stress concentrates in pristine rock adjoining the fault where special conditions for the fan-mechanism nucleation are created, while further dynamic propagation of the new fault (earthquake) occurs at low field stresses even below the frictional strength.

  9. Pneumatic Rupture of Rectosigmoid; a Case Report

    OpenAIRE

    Mohammad Montazeri; Bahman Farhangi; Mahmood Montazeri

    2014-01-01

    Pneumatic rectosigmoid rapture is usually occurred following the inappropriate fun by direct entering a high volume of the air through the pneumatic device to the anus. Such an event was reported for the first time in 1904 by Stone. Diagnosis and treatment of such injuries are often delayed because of some social limitations and preventing the patient form explaining the event. Colon sigmoid rupture and pneumoperitoneum is one of the most dangerous and life treating complications of entering ...

  10. The Effects of Fetal Surgery on Retinopathy of Prematurity Development

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    Sudha Nallasamy

    2009-10-01

    Full Text Available Background: Fetal surgery is selectively offered for severe or life-threatening fetal malformations. These infants are often born prematurely and are thus at risk for retinopathy of prematurity (ROP. It is not known whether fetal surgery confers an increased risk of developing severe ROP relative to published rates in standard premature populations ≤37 weeks of age grouped by birth weight (

  11. Radiological evaluation of sinus valsalva rupture

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    Lee, Yul; Park, Jae Hyung; Yeon, Kyung Mo; Han, Man Chung [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1984-03-15

    We obtained the following results by reviewing the radiographic findings of 15 cases of Sinus valsalva rupture who were diagnosed surgically at Seoul National University Hospital since 1979. 1. Among distribution was from 15 years to 40 years with the mean age of 24 years. Among the 15 cases, 9 cases were male and 7 were female. 2. Ruptured sinus is right coronary sinus projecting to right ventricle in all 15 cases. Combined diseases are ventricular septal defect in 12 cases, Aortic Valvular heart disease in 4 cases, and narrowing of right ventricular outflow tract in 2 cases, and aneurysmal dilatation of right pulmonary artery in 1 cases. 3. Chest X-ray findings were that of left to right shunt, i.e, cardiomegaly, increased pulmonary vascularity but were normal in 3 cases. 4. Aortography showed sequential leakage of dye from right coronary sinus to right ventricle and finally to pulmonary artery in 9 cases, and in 9 cases of them the leakage is directly to right ventricular outflow tract without filling of sinus portion of the ventricle., i.e., type I. 5. The leakage was well shown in left ventricular diastolic phase and not shown in systolic phase. 6. Ventricular septal defects were not detected definitely in spite of taking left ventriculography. 7. Cine angiography is essential for detecting accurate site, degree and direction of sinus valsalva rupture and other associated cardiac abnormality.

  12. Endovascular treatment for ruptured basilar apex aneurysm

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    Sheng LI

    2011-12-01

    Full Text Available Objective The present study aims to prove the effectiveness and safety of endovascular interventional therapy for ruptured basilar apex aneurysm.Methods The imaging data,methods of endovascular treatment,and clinical results of 12 patients suffering from ruptured basilar apex aneurysms from January 2001 to December 2009 were retrospectively analyzed.The 12 patients were composed of 5 males and 7 females,and their ages ranged from 21 years to 58 years.Results Nine patients suffered from narrow-necked aneurysms,which were directly embolized,and the other three suffered from wide-necked aneurysms,which were embolized using a microstent.Eight aneurysms were completely embolized,and the other four were partly embolized.No rebleeding occurred within the follow-up period of 12 months to 36 months,and all patients recovered well without neurological defects.Conclusions Therefore,endovascular treatment for ruptured basilar apex aneurysm is a semi-invasive,safe,and effective method.

  13. Isolated unilateral rupture of the alar ligament.

    Science.gov (United States)

    Wong, Sui-To; Ernest, Kimberly; Fan, Grace; Zovickian, John; Pang, Dachling

    2014-05-01

    Only 6 cases of isolated unilateral rupture of the alar ligament have been previously reported. The authors report a new case and review the literature, morbid anatomy, and pathogenesis of this rare injury. The patient in their case, a 9-year-old girl, fell head first from a height of 5 feet off the ground. She presented with neck pain, a leftward head tilt, and severe limitation of right rotation, extension, and right lateral flexion of the neck. Plain radiographs and CT revealed no fracture but a shift of the dens toward the right lateral mass of C-1. Magnetic resonance imaging of the cervical spine showed signal hyperintensity within the left dens-atlas space on both T1- and T2-weighted sequences and interruption of the expected dark signal representing the left alar ligament, suggestive of its rupture. After 12 weeks of immobilization in a Guilford brace, MRI showed lessened dens deviation, and the patient attained full and painless neck motion. Including the patient in this case, the 7 patients with this injury were between 5 and 21 years old, sustained the injury in traffic accidents or falls, presented with marked neck pain, and were treated with external immobilization. All patients had good clinical outcome. The mechanism of injury is hyperflexion with rotation. Isolated unilateral alar ligament rupture is a diagnosis made by excluding associated fracture, dislocation, or disruption of other major ligamentous structures in the craniovertebral junction. CT and MRI are essential in establishing the diagnosis. External immobilization is adequate treatment.

  14. Effects of Apparent Supersonic Ruptures for Strike-slip Rupture: Should We Consider it in the Seismic Hazard Analysis?

    Science.gov (United States)

    Barrows, M. B.; Shao, G.; Ji, C.

    2009-12-01

    Recent numerical studies indicated that the supersonic rupture could produce larger off-fault damage at distant sites than the sub-shear rupture, due to the famous "mach cone" effect (Dunham and Archuleta, 2005; Bhat et al, 2007). These results were obtained using the steady-state rupture simulations in a half-space earth. For more realistic layered or 3D earth models, we should also consider the effects of apparent supersonic rupture, i.e., the deep rupture is still in a speed slower than the local shear velocity, but faster than the near surface S or even the P wave velocity. The apparent super-shear rupture could excite the mach effect, but how large it is has not yet been quantitatively addressed. In this study, we explore this possibility by performing numerical simulations for pure strike-slip ruptures on a vertical fault inside various layered earth models.

  15. Simultaneous reconstruction of quadriceps tendon rupture after TKA and neglected Achilles tendon rupture.

    Science.gov (United States)

    Lee, Yong Seuk; Min, Byoung-Hyun; Han, Kyeong-Jin; Cho, Jae Ho; Han, Seung Hwan; Lee, Doo-Hyung; Oh, Kyung Soo

    2010-05-12

    We report a case of simultaneous reconstruction of a quadriceps tendon rupture after total knee arthroplasty (TKA) and neglected Achilles tendon rupture, which occurred before TKA with an ipsilateral hamstring autograft. A 64-year-old woman presented with persistent right knee pain. She also had right heel pain and had received multiple steroid injections at the knee joint and heel. On examination, she showed osteoarthritis in the medial and lateral compartments of the knee joint and an Achilles tendon rupture in the ipsilateral limb. There was skin dimpling and the proximal portion of tendon was migrated. We performed TKA, and the postoperative course was satisfactory. She returned 3 months postoperatively, however, with skin dimpling around the suprapatellar area and weakness of knee extension. Her ankle symptoms were also aggravated because she could not use the knee joint freely. We performed simultaneous reconstruction of the quadriceps tendon and the Achilles tendon using an ipsilateral hamstring autograft.Hamstring autograft offers a good alternative treatment option for rupture repair, particularly with concommitant ruptures of multiple sites when primary repair is not possible or the viability of repaired tissue is poor.

  16. Animal models of premature and retarded ejaculation.

    Science.gov (United States)

    Waldinger, Marcel D; Olivier, Berend

    2005-06-01

    Most of our current understanding of the neurobiology of sexual behavior and ejaculatory function has been derived from animal studies using rats with normal sexual behaviour. However, none of these proposed models adequately represents human ejaculatory disorders. Based on the "ejaculation distribution theory", which postulates that the intravaginal ejaculation latency time in men is represented by a biological continuum, we have developed an animal model for the research of premature and delayed ejaculation. In this model, a large number of male Wistar rats are investigated during 4-6 weekly sexual behavioural tests. Based on the number of ejaculations during 30 min tests, rapid and sluggish ejaculating rats are distinguished, each representing approximately 10% at both ends of a Gaussian distribution. Together with other parameters, such as ejaculation latency time, these rats at either side of the spectrum resemble men with premature and delayed ejaculation, respectively. Comparable to the human situation, in a normal population of rats, endophenotypes exist with regard to basal sexual (ejaculatory) performance.

  17. Neuro-ophthalmic manifestations of prematurity.

    Science.gov (United States)

    Chhablani, Preeti Patil; Kekunnaya, Ramesh

    2014-10-01

    Increasing rates of preterm births coupled with better survival of these infants have resulted in higher prevalence of systemic and ocular complications associated with prematurity. In addition to retinopathy of prematurity, infants who are born preterm may suffer from severe visual impairment as a result of hypoxic ischemic encephalopathy, hypoglycemia, and other metabolic imbalances. The effect of these processes on the anterior visual pathway may result in optic atrophy, optic nerve hypoplasia or optic disc cupping and affection of the posterior visual pathway leads to cortical visual impairment (CVI). Other ocular associations include strabismus, nystagmus, and ocular motor abnormalities such as tonic down gaze and defective saccades and pursuits. Cortical and subcortical involvement also manifests as defects in functional vision and these have not yet been completely understood. Children with CVI may have visual field defects, photophobia, defective visual processing, and deficient color vision. Since most of these children also suffer from additional systemic disabilities, evaluation, and management remains a challenge. However, early diagnosis and initiation of rehabilitation therapy can prove to be of significant benefit in these children.

  18. [Intraventricular haemorrhage in premature newborn babies].

    Science.gov (United States)

    Nazar, N

    This work is the product of the checking of the pathogenesis, incidence, treatment, and prognostic of the intraventricular hemorrhage in the premature newborn. In the revised publications, that include important series of following, this pathology is present in 25% of the infants weighing less than 1,500 g, in which the mortality and morbidity is greater than that of normal newborns, since the development of intraventricular hemorrhage can produce alterations of cerebral blood flow in the immature germinal matrix and in the microvascular net. In consequence the prevention of the intraventricular hemorrhage is directly related with its pathogenesis. It is said that the use of dexamethasone steroids in low doses in the prenatal period, and low doses of indomethacin in the postnatal period, can give better neuroprotection. The surgical treatment is exceptional and has very precise indications, when a progresive hydrocephalus of later apparition is proven. Therefore in premature newborns with intraventricular hemorrhage the best actual treatment is to use an appropiate pharmacological and medical following

  19. The pathophysiology of acquired premature ejaculation.

    Science.gov (United States)

    McMahon, Chris G; Jannini, Emmanuele A; Serefoglu, Ege C; Hellstrom, Wayne J G

    2016-08-01

    The second Ad Hoc International Society for Sexual Medicine (ISSM) Committee for the Definition of Premature Ejaculation defined acquired premature ejaculation (PE) as a male sexual dysfunction characterized by a the development of a clinically significant and bothersome reduction in ejaculation latency time in men with previous normal ejaculatory experiences, often to about 3 minutes or less, the inability to delay ejaculation on all or nearly all vaginal penetrations, and the presence of negative personal consequences, such as distress, bother, frustration and/or the avoidance of sexual intimacy. The literature contains a diverse range of biological and psychological etiological theories. Acquired PE is commonly due to sexual performance anxiety, psychological or relationship problems, erectile dysfunction (ED), and occasionally prostatitis and hyperthyroidism, consistent with the predominant organic etiology of acquired PE, men with this complaint are usually older, have a higher mean BMI and a greater incidence of comorbid disease including hypertension, sexual desire disorder, diabetes mellitus, chronic prostatitis, and ED compared to lifelong, variable and subjective PE.

  20. Premature ovarian insufficiency: Pathogenesis and management

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    Anna J Fenton

    2015-01-01

    Full Text Available The term premature ovarian insufficiency (POI describes a continuum of declining ovarian function in a young woman, resulting in an earlier than average menopause. It is a term that reflects the variable nature of the condition and is substantially less emotive than the formerly used "premature ovarian failure" which signaled a single event in time. Contrary to the decline in the age of menarche seen over the last 3-4 decades there has been no similar change in the age of menopause. In developed nations, the average age for cessation of menstrual cycles is 50-52 years. The age is younger among women from developing nations. Much has been written about POI despite a lack of good data on the incidence of this condition. It is believed that 1% of women under the age of 40 years and 0.1% under the age of 30 years will develop POI. Research is increasingly providing information about the pathogenesis and treatments are being developed to better preserve ovarian function during cancer treatment and to improve fertility options. This narrative review summarizes the current literature to provide an approach to best practice management of POI.

  1. Treatment of threshold retinopathy of prematurity

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    Deshpande Dhanashree

    1998-01-01

    Full Text Available This report deals with our experience in the management of threshold retinopathy of prematurity (ROP. A total of 45 eyes of 23 infants were subjected to treatment of threshold ROP. 26.1% of these infants had a birth weight of >l,500 gm. The preferred modality of treatment was laser indirect photocoagulation, which was facilitated by scleral depression. Cryopexy was done in cases with nondilating pupils or medial haze and was always under general anaesthesia. Retreatment with either modality was needed in 42.2% eyes; in this the skip areas were covered. Total regression of diseases was achieved in 91.1% eyes with no sequelae. All the 4 eyes that progressed to stage 5 despite treatment had zone 1 disease. Major treatment-induced complications did not occur in this series. This study underscores the importance of routine screening of infants upto 2,000 gm birth weight for ROP and the excellent response that is achieved with laser photocoagulation in inducing regression of threshold ROP. Laser is the preferred method of treatment in view of the absence of treatment-related morbidity to the premature infants.

  2. Neuro-ophthalmic manifestations of prematurity

    Directory of Open Access Journals (Sweden)

    Preeti Patil Chhablani

    2014-01-01

    Full Text Available Increasing rates of preterm births coupled with better survival of these infants have resulted in higher prevalence of systemic and ocular complications associated with prematurity. In addition to retinopathy of prematurity, infants who are born preterm may suffer from severe visual impairment as a result of hypoxic ischemic encephalopathy, hypoglycemia, and other metabolic imbalances. The effect of these processes on the anterior visual pathway may result in optic atrophy, optic nerve hypoplasia or optic disc cupping and affection of the posterior visual pathway leads to cortical visual impairment (CVI. Other ocular associations include strabismus, nystagmus, and ocular motor abnormalities such as tonic down gaze and defective saccades and pursuits. Cortical and subcortical involvement also manifests as defects in functional vision and these have not yet been completely understood. Children with CVI may have visual field defects, photophobia, defective visual processing, and deficient color vision. Since most of these children also suffer from additional systemic disabilities, evaluation, and management remains a challenge. However, early diagnosis and initiation of rehabilitation therapy can prove to be of significant benefit in these children.

  3. The significance of genetics in pathophysiologic models of premature birth.

    Science.gov (United States)

    Uberos, Jose

    2017-05-31

    Prematurity is a major health problem in all countries, especially in certain ethic groups and increasing recurrence imply the influence of genetic factors. Published genetic polymorphisms are identified in relation to the 4 pathophysiological models of prematurity described: Chorioamniotic-decidual inflammation, premature contraction pathway, decidual haemorrhage and susceptibility to environmental toxins. 240 articles are identified, 52 articles are excluded because they are not original, not written in English or duplicated. From them 125 articles were included in qualitative analysis This review aims to update recent knowledge about genes associated with premature birth.

  4. [Induction of labor in patients with premature rupture of membranes in term pregnancy using dinoprostone vs oxytocin. An aleatory study].

    Science.gov (United States)

    Domínguez Salgado, C R; Gorostieta García, A; Vázquez Bretón, S

    1999-10-01

    It was accomplished a random comparative study to evaluate the effects of dinoprostone in the Hospital de Gineco Obstetricia No. 60 of the Mexican Institute of the Social Security, from June of 1997 to December of the same year, in relationship to the inducement cervical repening and vaginal delivery in patients with score less than or equal Bishop to 4. They were studied a total of 156 patients split into two groups: 78 patients who were administered by intracervical gel of Dinoprostone and to the remainders 78 were administered oxitocin with the same purpose, being this last the control group. We found that the duration time of induction with dinoprostone is 2 hours in average less than the inducement with oxitocin (p > 0.05). The were achieved 67 deliveries with dinoprostone and 65 deliveries with oxitocina, being not significantly. (p 0.05). We can conclude that the dinoprostone intracervical application reduce the induction and expulsion time, with better conditions of the new born, and less percent of infectious complications, in relationship to the Oxitocin control group.

  5. Amniotic Fluid Glucose Concentration: A Marker for Infection in Preterm Labor and Preterm Premature Rupture of Membranes

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    Gary A. Dildy

    1994-01-01

    Full Text Available Amniotic fluid Gram stain and culture have been utilized as laboratory tests of microbial invasion of the amniotic cavity. The Gram stain of amniotic fluid has a low sensitivity in the detection of clinical infection or microbial invasion of the amniotic cavity, and amniotic fluid culture results are not immediately available for management decisions. Glucose concentration is used to diagnose infection in other sites such as cerebrospinal fluid.

  6. Oligodramnia sem rotura das membranas amnióticas: resultados perinatais Oligohydramnios without premature rupture of membranes: perinatal outcomes

    OpenAIRE

    José Mauro Madi; Edson Nunes de Morais; Breno Fauth de Araújo; Renato Luís Rombaldi; Sônia Regina Cabral Madi; Luciano Ártico; Natacha Araújo Machado

    2005-01-01

    OBJETIVO: avaliar os resultados perinatais em casos de oligodramnia sem rotura de membranas amnióticas. MÉTODOS: foram estudados retrospectivamente 51 casos consecutivos de oligodramnia (índice de líquido amniótico (ILA) menor que 5 cm) em nascimentos ocorridos no período de março de 1998 a setembro de 2001. Compararam-se os dados obtidos aos de 61 casos com quantidade intermediária e normal de líquido amniótico (ILA >5 cm). Analisaram-se variáveis maternas e neonatais, bem como taxas de mort...

  7. A comparative study between PGE1 and PGE2 for induction of labour in premature rupture of membrane at term

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    Abhishek Oza

    2016-01-01

    Conclusions: Both the molecules of prostaglandins are efficient for labour induction in term PROM. Though, PGE1 (tab. Misoprostol is faster acting as compare to PGE2 (dinoprostone gel even with low bishop score. But it can lead to complications like hyperstimulation, fetal distress and postpartum hemorrhage if not used properly. So, tab misoprostol is not a safe drug where continuous monitoring of women is not available. [Int J Reprod Contracept Obstet Gynecol 2016; 5(1.000: 202-205

  8. Which Dynamic Rupture Parameters can be Resolved?

    Science.gov (United States)

    Peyrat, S.; Olsen, K.; Madariaga, R.

    2001-12-01

    We use finite-difference simulations in models of the 1992 Mw 7.3 Landers earthquake to examine which dynamic rupture parameters may be recovered for large crustal earthquakes. By trial-and-error inversion Peyrat et al. (2001) found two simple models with constant slip-weakening friction which generated a satisfactory fit between synthetic and observed strong motion data: an asperity model, with spatially-varying initial stress and constant yield stress, and a barrier model with constant initial stress and spatially-varying yield stress. However, there is some evidence from inversion of seismic data for large earthquakes (i.e., Ide and Takeo, 1997, for the 1995 Kobe earthquake), that the slip-weakening distance Dc may vary spatially. In particular, Ide and Takeo found a larger Dc in the shallower parts of the crust compared to the deeper parts. Possible causes of such variation include the increase of elastic rigidity with depth and a fundamentally different friction in the near-surface layers. Here, we examine the effects of laterally and vertically varying Dc on the strong motion synthetics computed by our dynamic rupture models. We generate an alternative barrier model with constant initial and yield stress but spatially-varying Dc which, as our two previous rupture models of the Landers event, generate synthetics in agreement with strong motion data. Thus, we have constructed three well-posed mechanical models of the Landers earthquake that satisfy available strong motion data and which are end-members of a large family of dynamically correct models. Our findings confirm an earlier hypothesis that barrier and asperity models of an earthquake generate similar signature in the seismic radiation (Madariaga, 1979). Therefore, it may not be possible to separate stress and Dc using rupture modeling. Instead, we propose to characterize dynamic rupture propagation by the local non-dimensional parameter κ introduced by Madariaga and Olsen (2000), which is expressed in

  9. Coupling geodynamic earthquake cycles and dynamic ruptures

    Science.gov (United States)

    van Zelst, Iris; van Dinther, Ylona; Gabriel, Alice-Agnes; Heuret, Arnauld

    2016-04-01

    Studying the seismicity in a subduction zone and its effects on tsunamis requires diverse modelling methods that span spatial and temporal scales. Hundreds of years are necessary to build the stresses and strengths on a fault, while consequent earthquake rupture propagation is determined by both these initial fault conditions and the feedback of seismic waves over periods of seconds up to minutes. This dynamic rupture displaces the sea floor, thereby causing tsunamis. The aim of the ASCETE (Advanced Simulations of Coupled Earthquake and Tsunami Events) project is to study all these aspects and their interactions. Here, we present preliminary results of the first aspects in this modelling chain: the coupling of a seismo-thermo-mechanical (STM) code to the dynamic rupture model SeisSol. STM models of earthquake cycles have the advantage of solving multiple earthquake events in a self-consistent manner concerning stress, strength and geometry. However, the drawback of these models is that they often lack in spatial or temporal resolution and do not include wave propagation. In contrast, dynamic rupture models solve for frictional failure coupled to seismic wave propagation. We use the software package SeisSol (www.seissol.org) based on an ADER-DG discretization allowing high-order accuracy in space and time as well as flexible tetrahedral meshing. However, such simulations require assumptions on the initial fault stresses and strengths and its geometry, which are hard to constrain due to the lack of near-field observations and the complexity of coseismic conditions. By adapting the geometry as well as the stress and strength properties of the self-consistently developing non-finite fault zones from the geodynamic models as initial conditions for the dynamic rupture models, the advantages of both methods are exploited and modelling results may be compared. Our results show that a dynamic rupture can be triggered spontaneously and that the propagating rupture is

  10. 胎盘早剥危险因素的临床分析%Clinical analysis of risk factors for premature separation of placenta

    Institute of Scientific and Technical Information of China (English)

    杨丽华; 谢穗

    2013-01-01

    目的 分析胎盘早剥的危险因素,为胎盘早剥的防治提供参考.方法 将到该院就治的74例胎盘早剥孕产妇的临床资料进行回顾性分析,并以50例健康孕产妇作为对照,对胎盘早剥危险因素进行Logistic 回归分析.结果 Logistic 回归分析显示74例胎盘早剥孕产妇危险因素主要有妊娠高血压、机械损伤、长期吸烟史、滥用可卡因史、胎膜早破、血栓形成倾向等.结论 胎盘早剥的危险因素复杂多样,孕产妇应加强孕期检查,及早诊治,改善新生儿不良预后.%Objective To analyze the risk factors for premature separation of placenta,and to provide reference for the prevention and treatment of premature separation of placenta. Methods Clinical data were retrospectively analyzed of 74 cases of premature separation of placenta, while 50 healthy pregnant women were set as controls. Logistic regression analysis was made of the risk factors of premature separation of placenta. Results Logistic regression analysis showed that the risk factors included hypertension,mechanical damage,long history of smoking, history of cocaine abuse, premature rupture of membranes and thrombophilia. Conclusion The risk factors for premature separation of placenta are complex and diverse. Ihe maternal should strengthen prenatal,early diagnosis and treatment to improve the poor prognosis of newborns.

  11. ClinicalAnalysisof92CasesofPrematureRuptureofMembranesOccurredReasons%92例胎膜早破发生原因的临床分析

    Institute of Scientific and Technical Information of China (English)

    陈杰

    2013-01-01

    Objective Analyze the reasons for the occurrence of 92 cases of premature rupture of membranes, explore the diagnosis and treatment process, premature rupture of membranes to reduce the incidence of perinatal complications, reduce perinatal mortality.Methods On 1 June 2010 in the First Affiliated Hospital of Shangqiu Medical College maternal obstetric hospital 92 patients with PROM were retrospectively analyzed.Results Premature rupture of membranes accounted for 10.2%of the total number of deliveries, the main reason for the lower genital tract infections (such as:vaginitis), induction of labor history of multiple miscarriages, breech. Actively miscarriage, handling more than 35 weeks pregnant as long as possible to seek to facilitate the treatment of fetal lung maturity can reduce the incidence of neonatal RDS.Conclusion Emphasis on reproductive health knowledge propaganda and education of pregnant women, universal access to sex education, providing quality contraceptive services is of great signiifcance to reduce the occurrence of premature rupture of membranes, reduce the incidence of perinatal complications, reduce perinatal mortality.%  目的对92例胎膜早破发生的原因进行分析,探讨诊治胎膜早破过程中减少围生期母婴并发症的发生,降低围生儿病死率。方法对2010年1~6月份在商丘医学高等专科学校第一附院产科住院的92例胎膜早破的孕产妇进行回顾性分析。结果胎膜早破占分娩总数的10.2%,其主要原因为下生殖道感染疾病(如:阴道炎)、有多次流产引产史、臀位等。处理上积极保胎,尽可能延长至孕35周以上,争取促进胎肺成熟治疗,可减少新生儿RDS的发生。结论重视孕期孕妇生殖保健知识宣传教育,普及性知识教育,提供优质的避孕技术服务,对降低胎膜早破的发生,减少围生期母婴并发症的发生,降低围生儿病死率具有重要意义。

  12. Brain ultrasonography in the premature infant.

    Science.gov (United States)

    Veyrac, Corinne; Couture, Alain; Saguintaah, Magali; Baud, Catherine

    2006-07-01

    Brain ultrasonography plays a central role in the detection and management of neonatal disease in the preterm infant. Although morphological study, using high-frequency transducers, remains the cornerstone of imaging, pulsed and colour Doppler scans provide additional information and improve the diagnostic and prognostic accuracy of ultrasonography. Particular features of normal brain US in the extremely preterm infant are reported. Cerebral haemorrhage and its different patterns (intraventricular haemorrhage and periventricular hemorrhagic infarction) are described. The value of Doppler techniques is emphasized, e.g. demonstration of coloured signal within the aqueduct of Sylvius, visualization of patency of the terminal veins, demonstration of Doppler spectrum fluctuations, recognition of low blood flow, and the detection of vasodilatation. The sonographic diagnosis of periventricular leucomalacia and its difficulties are documented. Some uncommon brain lesions of the premature infant are illustrated, e.g. gangliothalamic ischaemic damage, cortical necrosis, focal infarcts, etc. The importance of repeating the US examinations until near term is highlighted.

  13. Modern Approach in Premature Ovarian Failure

    Directory of Open Access Journals (Sweden)

    Pacu Irina

    2014-09-01

    Full Text Available Premature ovarian failure (POF is a condition affecting 1-2% of women younger than 40 years of age, characterized by amenorrhea, hypoestrogenism and elevated gonadotropin levels. In the last years it became a problem of social health interest as the frequency increased due to environmental factors and new, efficient methods for cancer treatment in young women. Few genes have beed identified to explain cases of POF but there are also autoimmune associated conditions and an increasing number of iatrogenic cases (chemotherapy, surgery, radiotherapy. Modern approach in POF means not only a precise etiological diagnosis, but also a correct counseling for these patients who often want to become parents, and a chance for a healthy life without the long term consequences of estrogen deprivation from an early age. In vitro fertilization (IVF techniques can be useful for certain cases but research is needed on strategies to improve fertility for women who have follicles remaining in the ovaries.

  14. Modeling premature brain injury and recovery

    Science.gov (United States)

    Scafidi, Joey; Fagel, Devon M.; Ment, Laura R.; Vaccarino, Flora M.

    2009-01-01

    Premature birth is a growing and significant public health problem because of the large number of infants that survive with neurodevelopmental sequelae from brain injury. Recent advances in neuroimaging have shown that although some neuroanatomical structures are altered, others improve over time. This review outlines recent insights into brain structure and function in these preterm infants at school age and relevant animal models. These animal models have provided scientists with an opportunity to explore in depth the molecular and cellular mechanisms of injury as well as the potential of the brain for recovery. The endogenous potential that the brain has for neurogenesis and gliogenesis, and how environment contributes to recovery, are also outlined. These preclinical models will provide important insights into the genetic and epigenetic mechanisms responsible for variable degrees of injury and recovery, permitting the exploration of targeted therapies to facilitate recovery in the developing preterm brain. PMID:19482072

  15. Gastric Pneumatosis in a Premature Neonate

    Directory of Open Access Journals (Sweden)

    Yuk Joseph Ting

    2011-09-01

    Full Text Available Gastric pneumatosis is extremely rare during infancy. It has been reported in association with necrotizing enterocolitis or congenital abnormalities such as pyloric stenosis. Here, we report a case of gastric pneumatosis in a premature neonate on synchronized nasal intermittent positive pressure ventilation. No pneumatosis was noted in the rest of the bowel or esophagus. There could have been mild damage in the gastric mucosa, either related to the placement of the feeding tube or secondary to the use of indomethacin or both. The condition was further aggravated by noninvasive ventilation. An increase in intragastric pressure resulted in the submucosal dissection of air followed by the development of gastric pneumatosis. Conservative management strategies, including the use of a nasogastric tube for decompression and the withholding of feeding, successfully managed the gastric pneumatosis in our patient. An uneventful recovery was made after conservative management. Prompt recognition and evaluation of this condition were essential for making the diagnosis.

  16. Classification and definition of premature ejaculation.

    Science.gov (United States)

    Parnham, Arie; Serefoglu, Ege Can

    2016-08-01

    Premature ejaculation (PE) is a poorly understood condition and is considered as the most common sexual disorder in men. The ambiguity surrounding PE is in part due to the difficulty in conducting and interpreting research in the absence of a standardised definition that adequately encompasses the characteristics of these patients. An enhanced awareness of sexual dysfunctions in the recent decades has lead to an increase in scientific research that has challenged the traditional paradigm regarding PE. This has also enabled to establish a universal definition and classification of the disease. A move to a more evidence based approach has improved the clinicians' ability to define those who need medical treatment, as well as perform further research in this complex condition.

  17. Bmi-1 absence causes premature brain degeneration.

    Directory of Open Access Journals (Sweden)

    Guangliang Cao

    Full Text Available Bmi-1, a polycomb transcriptional repressor, is implicated in cell cycle regulation and cell senescence. Its absence results in generalized astrogliosis and epilepsy during the postnatal development, but the underlying mechanisms are poorly understood. Here, we demonstrate the occurrence of oxidative stress in the brain of four-week-old Bmi-1 null mice. The mice showed various hallmarks of neurodegeneration including synaptic loss, axonal demyelination, reactive gliosis and brain mitochondrial damage. Moreover, astroglial glutamate transporters and glutamine synthetase decreased in the Bmi-1 null hippocampus, which might contribute to the sporadic epileptic-like seizures in these mice. These results indicate that Bmi-1 is required for maintaining endogenous antioxidant defenses in the brain, and its absence subsequently causes premature brain degeneration.

  18. Periodic heart rate decelerations in premature infants.

    Science.gov (United States)

    Flower, Abigail A; Moorman, J Randall; Lake, Douglas E; Delos, John B

    2010-04-01

    The pacemaking system of the heart is complex; a healthy heart constantly integrates and responds to extracardiac signals, resulting in highly complex heart rate patterns with a great deal of variability. In the laboratory and in some pathological or age-related states, however, dynamics can show reduced complexity that is more readily described and modeled. Reduced heart rate complexity has both clinical and dynamical significance - it may provide warning of impending illness or clues about the dynamics of the heart's pacemaking system. In this paper, we describe simple and interesting heart rate dynamics that we have observed in premature human infants - reversible transitions to large-amplitude periodic oscillations - and we show that the appearance and disappearance of these periodic oscillations can be described by a simple mathematical model, a Hopf bifurcation.

  19. Enteral nutrition of the premature infant

    Directory of Open Access Journals (Sweden)

    Su Jin Cho

    2010-01-01

    Full Text Available Early nutritional support for preterm infants is critical because such support influences long-term outcome. Minimal enteral feeding should be initiated as soon as possible if an infant is stable and if feeding advancement is recommended as relevant to the clinical course. Maternal milk is the gold standard for enteral feeding, but fortification may be needed to achieve optimal growth in a rapidly growing premature infant. Erythromycin may aid in promoting gastrointestinal motility in cases that exhibit feeding intolerance. Selected preterm infants need vitamins, mineral supplements, and calorie enhancers to meet their nutritional needs. Despite all that is known about this topic, additional research is needed to guide postdischarge nutrition of preterm infants in order to maintain optimal growth and neurodevelopment.

  20. Premature and accelerated ageing: HIV or HAART?

    Directory of Open Access Journals (Sweden)

    Reuben Luke Smith

    2013-01-01

    Full Text Available Highly Active Anti-Retroviral Therapy (HAART has significantly increased life expectancy of the HIV-positive population. Nevertheless, the average lifespan of HIV patients remains shorter compared to uninfected individuals. Immunosenescence, a current explanation for this difference invokes heavily on viral stimulus despite HAART efficiency in viral suppression. We propose here that the premature and accelerated ageing of HIV patients can also be caused by adverse effects of antiretroviral drugs, specifically those that affect the mitochondria. The Nucleoside Reverse Transcriptase Inhibitor (NRTI antiretroviral drug class for instance, is known to cause depletion of mitochondrial DNA via inhibition of the mitochondrial specific DNA polymerase-ƴ. Besides NRTIs, other antiretroviral drug classes such as Protease Inhibitors also cause severe mitochondrial damage by increasing oxidative stress and diminishing mitochondrial function. We also discuss important areas for future research and argue in favour of the use of C. elegans as a novel model system for studying these effects.

  1. Missed Iatrogenic Bladder Rupture Following Normal Vaginal Delivery.

    Science.gov (United States)

    Baheti, Vidyasagar H; Wagaskar, Vinayak G; Patwardhan, Sujata K

    2015-10-01

    Bladder rupture following caesarian section is well documented complications. Intraperitoneal bladder rupture following normal vaginal delivery is very rare. Hereby, we present a case report of intraperitoneal bladder rupture presented late following normal vaginal delivery. We report a case of spontaneous intraperitoneal urinary bladder rupture following uneventful outlet forceps delivery in a 22-year-old primi gravid woman with gestational diabetes mellitus and fetal macrosomia who presented with large urinary ascites, anuria and renal failure. Emergent exploratory laparotomy with repair of the intraperitoneal bladder rupture helped to prevent its potential complications. Postpartum patients who undergo episiotomy or perineal repair may land up in unnoticed urinary retention which may rarely terminate in spontaneous urinary bladder rupture. Awareness of its manifestations amongst emergency physician would help to initiate appropriate timely management.

  2. Mechanical ventilation of the premature neonate.

    Science.gov (United States)

    Brown, Melissa K; DiBlasi, Robert M

    2011-09-01

    Although the trend in the neonatal intensive care unit is to use noninvasive ventilation whenever possible, invasive ventilation is still often necessary for supporting pre-term neonates with lung disease. Many different ventilation modes and ventilation strategies are available to assist with the optimization of mechanical ventilation and prevention of ventilator-induced lung injury. Patient-triggered ventilation is favored over machine-triggered forms of invasive ventilation for improving gas exchange and patient-ventilator interaction. However, no studies have shown that patient-triggered ventilation improves mortality or morbidity in premature neonates. A promising new form of patient-triggered ventilation, neurally adjusted ventilatory assist (NAVA), was recently FDA approved for invasive and noninvasive ventilation. Clinical trials are underway to evaluate outcomes in neonates who receive NAVA. New evidence suggests that volume-targeted ventilation modes (ie, volume control or pressure control with adaptive targeting) may provide better lung protection than traditional pressure control modes. Several volume-targeted modes that provide accurate tidal volume delivery in the face of a large endotracheal tube leak were recently introduced to the clinical setting. There is ongoing debate about whether neonates should be managed invasively with high-frequency ventilation or conventional ventilation at birth. The majority of clinical trials performed to date have compared high-frequency ventilation to pressure control modes. Future trials with premature neonates should compare high-frequency ventilation to conventional ventilation with volume-targeted modes. Over the last decade many new promising approaches to lung-protective ventilation have evolved. The key to protecting the neonatal lung during mechanical ventilation is optimizing lung volume and limiting excessive lung expansion, by applying appropriate PEEP and using shorter inspiratory time, smaller tidal

  3. Delayed umbilical cord clamping in premature neonates.

    Science.gov (United States)

    Kaempf, Joseph W; Tomlinson, Mark W; Kaempf, Andrew J; Wu, YingXing; Wang, Lian; Tipping, Nicole; Grunkemeier, Gary

    2012-08-01

    Delayed umbilical cord clamping is reported to increase neonatal blood volume. We estimated the clinical outcomes in premature neonates who had delayed umbilical cord clamping compared with a similar group who had early umbilical cord clamping. This was a before-after investigation comparing early umbilical cord clamping with delayed umbilical cord clamping (45 seconds) in two groups of singleton neonates, very low birth weight (VLBW) (401-1,500 g) and low birth weight (LBW) (greater than 1,500 g but less than 35 weeks gestation). Neonates were excluded from delayed umbilical cord clamping if they needed immediate major resuscitation. Primary outcomes were provision of delivery room resuscitation, hematocrit, red cell transfusions, and the principle Vermont Oxford Network outcomes. In VLBW neonates (77 delayed umbilical cord clamping, birth weight [mean±standard deviation] 1,099±266 g; 77 early umbilical cord clamping 1,058±289 g), delayed umbilical cord clamping was associated with less delivery room resuscitation, higher Apgar scores at 1 minute, and higher hematocrit. Delayed umbilical cord clamping was not associated with significant differences in the overall transfusion rate, peak bilirubin, any of the principle Vermont Oxford Network outcomes, or mortality. In LBW neonates (172 delayed umbilical cord clamping, birth weight [mean±standard deviation] 2,159±384 g; 172 early umbilical cord clamping 2,203±447 g), delayed umbilical cord clamping was associated with higher hematocrit and was not associated with a change in delivery room resuscitation or Apgar scores or with changes in the transfusion rate or peak bilirubin. Regression analysis showed increasing gestational age and birth weight and delayed umbilical cord clamping were the best predictors of higher hematocrit and less delivery room resuscitation. Delayed umbilical cord clamping can safely be performed in singleton premature neonates and is associated with a higher hematocrit, less delivery room

  4. Beryllium induces premature senescence in human fibroblasts.

    Science.gov (United States)

    Coates, Shannon S A; Lehnert, Bruce E; Sharma, Sunil; Kindell, Susan M; Gary, Ronald K

    2007-07-01

    After cells have completed a sufficient number of cell divisions, they exit the cell cycle and enter replicative senescence. Here, we report that beryllium causes proliferation arrest with premature expression of the principal markers of senescence. After young presenescent human fibroblasts were treated with 3 microM BeSO(4) for 24 h, p21 cyclin-dependent kinase inhibitor mRNA increased by >200%. Longer periods of exposure caused mRNA and protein levels to increase for both p21 and p16(Ink4a), a senescence regulator that prevents pRb-mediated cell cycle progression. BeSO(4) also caused dose-dependent induction of senescence-associated beta-galactosidase activity (SA-beta-gal). Untreated cells had 48 relative fluorescence units (RFU)/microg/h of SA-beta-gal, whereas 3 microM BeSO(4) caused activity to increase to 84 RFU/microg/h. In chromatin immunoprecipitation experiments, BeSO(4) caused p53 protein to associate with its DNA binding site in the promoter region of the p21 gene, indicating that p53 transcriptional activity is responsible for the large increase in p21 mRNA elicited by beryllium. Forced expression of human telomerase reverse transcriptase (hTERT) rendered HFL-1 cells incapable of normal replicative senescence. However, there was no difference in the responsiveness of normal HFL-1 fibroblasts (IC(50) = 1.9 microM) and hTERT-immortalized cells (IC(50) = 1.7 microM) to BeSO(4) in a 9-day proliferation assay. The effects of beryllium resemble those of histone deacetylase-inhibiting drugs, which also cause large increases in p21. However, beryllium produced no changes in histone acetylation, suggesting that Be(2+) acts as a novel and potent pharmacological inducer of premature senescence.

  5. Morbidity and mortality trends in very-very low birth weight premature infants in light of recent changes in obstetric care.

    Science.gov (United States)

    Varga, Péter; Berecz, Botond; Gasparics, Ákos; Dombi, Zsófia; Varga, Zsuzsa; Jeager, Judit; Magyar, Zsófia; Rigó, János; Joó, József Gábor; Kornya, László

    2017-04-01

    In this study, we describe trends in morbidity and mortality of preterm infants with less than 500mg birth weight in the changing landscape of obstetric and neonatal care. During a ten year study period between 2006 and 2016 we assessed outcome data for all neonates with less than 500mg birth weight born at our Neonatal Intensive Care Unit. We divided study subjects into two groups based on whether their birth date fell in the first half (2006-2010; n=39) versus the second half (2011-2015; n=27) of the study period comparing clinical outcomes in the two groups. We also assessed several clinical parameters for association with postnatal survival by comparing relative frequencies for each clinical parameter among surviving infants versus mortality cases. Survival rate for preterm neonates with less than 500mg birth weight born between 2006 and 2010 was 30.8%. This survival rate rose to 70.4% in the second half of the study period between 2011 and 2015 (ppremature birth was found to be predominantly associated with maternal hypertension or intrauterine growth restriction while in those who died premature birth due to premature rupture of membranes and spontaneous preterm labor were significantly more common. All surviving infants with less than 500mg birth weight were born via cesarean section whereas among those who died cesarean section had been performed in only 80% and vaginal delivery in 20% representing a significant difference between the groups (ppremature neonates with less than 500mg birth weight preterm delivery due to premature rupture of membranes and intrauterine infections represents the worse mortality risk. Steroid prophylaxis and measures to prevent and treat intrauterine infections with appropriate use of antibiotics can markedly improve survival in these cases. In premature neonates with less than 500mg birth weight survival is more favorable after cesarean section compared to vaginal delivery. Copyright © 2017. Published by Elsevier B.V.

  6. [Complete triploidy in a liveborn premature (author's transl)].

    Science.gov (United States)

    Rico, S; Skinner, C; Lechuga, J L; Fernández, E; Serrano, J; Casanova, M; Argemí, J; López, A; Castro, J M

    1980-01-01

    Authors describe the clinical, pathological and cytogenetic data of a polymalformed premature with a complete a triploidy 69,XXY). This rare condition (30 cases in the literature) may be suspected in a premature with broad posterior fontanella, eye and ear anomalies, syndactily between IV and III fingers/toes, intersexual status and mielomeningocele. Frequently the placenta presents a molar or micromolar degeneration.

  7. Lipid profile of women with premature ovarian failure

    NARCIS (Netherlands)

    Knauff, Erik A. H.; Westerveld, Hendrika E.; Goverde, Angelique J.; Eijkemans, Marinus J.; Valkenburg, Olivier; van Santbrink, Evert J. P.; Fauser, Bart C. J. M.; van der Schouw, Yvonne T.

    2008-01-01

    Objective: Earlier menopause is associated with a higher incidence of cardiovascular events later in life. Concurrent with the ages of menopausal transition, a shift in lipid profile takes place. Premature ovarian failure (POF) or premature menopause allows LIS to Study the effect of cessation of

  8. Palliative Care for Extremely Premature Infants and Their Families

    Science.gov (United States)

    Boss, Renee D.

    2010-01-01

    Extremely premature infants face multiple acute and chronic life-threatening conditions. In addition, the treatments to ameliorate or cure these conditions often entail pain and discomfort. Integrating palliative care from the moment that extremely premature labor is diagnosed offers families and clinicians support through the process of defining…

  9. Acupuncture Treatment for 98 Cases of Ventricular Premature Beat

    Institute of Scientific and Technical Information of China (English)

    Han Baojie; Wang Feng; Wang Xinzhong

    2008-01-01

    @@ Ventricular premature beat is a commonly encountered arrhythmia,which can occur in patients with and without cardiac diseases.In TCM.ventricular premature beat fall into the category of palpitation and obstruction of qi in the chest.The authors treated it with acupuncture and obtained satisfactory thera-peutic effects.A summary follows.

  10. Anemia of prematurity : time for a change in transfusion management?

    NARCIS (Netherlands)

    Khodabux, Chantal Muriel

    2013-01-01

    In this thesis we investigated clinical effects of allogeneic red blood cell (RBC) transfusions in premature infants, different transfusion volumes in relation to neonatal outcome in premature infants and the use of autologous cord blood (CB) as an alternative for allogeneic transfusions. Despite th

  11. Acetaminophen developmental pharmacokinetics in premature neonates and infants

    DEFF Research Database (Denmark)

    Anderson, Brian J; van Lingen, Richard A; Hansen, Tom G

    2002-01-01

    The aim of this study was to describe acetaminophen developmental pharmacokinetics in premature neonates through infancy to suggest age-appropriate dosing regimens.......The aim of this study was to describe acetaminophen developmental pharmacokinetics in premature neonates through infancy to suggest age-appropriate dosing regimens....

  12. Palliative Care for Extremely Premature Infants and Their Families

    Science.gov (United States)

    Boss, Renee D.

    2010-01-01

    Extremely premature infants face multiple acute and chronic life-threatening conditions. In addition, the treatments to ameliorate or cure these conditions often entail pain and discomfort. Integrating palliative care from the moment that extremely premature labor is diagnosed offers families and clinicians support through the process of defining…

  13. Feeding premature infants banked human milk homogenized by ultrasonic treatment.

    Science.gov (United States)

    Rayol, M R; Martinez, F E; Jorge, S M; Gonçalves, A L; Desai, I D

    1993-12-01

    Premature neonates fed ultrasonically homogenized human milk had better weight gain and triceps skin-fold thickness than did a control group given untreated human milk (p homogenization of human milk appears to minimize loss of fat and thus allows better growth of premature infants.

  14. Anemia of prematurity : time for a change in transfusion management?

    NARCIS (Netherlands)

    Khodabux, Chantal Muriel

    2013-01-01

    In this thesis we investigated clinical effects of allogeneic red blood cell (RBC) transfusions in premature infants, different transfusion volumes in relation to neonatal outcome in premature infants and the use of autologous cord blood (CB) as an alternative for allogeneic transfusions. Despite th

  15. A Rare Case of Adductor Longus Muscle Rupture

    Science.gov (United States)

    van de Kimmenade, R. J. L. L.; van Bergen, C. J. A.; van Deurzen, P. J. E.; Verhagen, R. A. W.

    2015-01-01

    An adductor longus muscle rupture is a rare injury. This case report describes a 32-year-old patient with an adductor longus rupture. The trauma mechanism was a hyperabduction movement during a soccer game. Nonoperative treatment was initiated. After a follow-up of 4 years, the patient was without pain but a small swelling was still visible. This report describes the anatomy, pathophysiology, and evidence-based treatment of adductor longus rupture. PMID:25918663

  16. A Rare Case of Adductor Longus Muscle Rupture

    Directory of Open Access Journals (Sweden)

    R. J. L. L. van de Kimmenade

    2015-01-01

    Full Text Available An adductor longus muscle rupture is a rare injury. This case report describes a 32-year-old patient with an adductor longus rupture. The trauma mechanism was a hyperabduction movement during a soccer game. Nonoperative treatment was initiated. After a follow-up of 4 years, the patient was without pain but a small swelling was still visible. This report describes the anatomy, pathophysiology, and evidence-based treatment of adductor longus rupture.

  17. Misdiagnosed Uterine Rupture of an Advanced Cornual Pregnancy

    Directory of Open Access Journals (Sweden)

    Christian Linus Hastrup Sant

    2012-01-01

    Full Text Available Cornual pregnancy is a diagnostic and therapeutic challenge with potential severe consequences if uterine rupture occurs with following massive intraabdominal bleeding. We report a case of a misdiagnosed ruptured cornual pregnancy occurring at 21 weeks of gestation. Ultrasound examination and computer tomography revealed no sign of abnormal pregnancy. The correct diagnosis was first made at emergency laparotomy. Uterine rupture should be considered in pregnant women presenting with abdominal pain and haemodynamic instability.

  18. Misdiagnosed uterine rupture of an advanced cornual pregnancy

    DEFF Research Database (Denmark)

    Sant, Christian Linus Hastrup; Andersen, Poul Erik

    2012-01-01

    Cornual pregnancy is a diagnostic and therapeutic challenge with potential severe consequences if uterine rupture occurs with following massive intraabdominal bleeding. We report a case of a misdiagnosed ruptured cornual pregnancy occurring at 21 weeks of gestation. Ultrasound examination...... and computer tomography revealed no sign of abnormal pregnancy. The correct diagnosis was first made at emergency laparotomy. Uterine rupture should be considered in pregnant women presenting with abdominal pain and haemodynamic instability....

  19. Venous rupture complicating hemodialysis access angioplasty: percutaneous treatments and outcomes

    Energy Technology Data Exchange (ETDEWEB)

    La, Young Jong; Goo, Dong Erk; Kim, Dae Ho; Lee, Hae Kyoung; Hong, Hyun Suk; Kwon, Gui Hyang; Choi, Duk Lin; Ynag, Sung Boo [College of Medicine, Soonchunhyang Univ., Seoul (Korea, Republic of)

    2002-03-01

    To evaluate the usefulness of percutaneous management and prognosis in venous rupture during angioplasty of hemodialytic arteriovenous fistulas. Among 814 patients who underwent angioplasty on account of inadequate hemodialysis, 63(39 women and 24 men aged 20-78 (mean, 55.8) years) were included in this study. All 63 had peripheral venous stenosis. Venous rupture was diagnosed when contrast leakage was seen at venography after percutaneous angioplasty (PTA). In order to manage venous rupture, the sites at which this occurred were compressed manually for 3-5 minutes or blood flow was blocked with a balloon catheter for the same period. In one case, a stent was inserted at the rupture site. Using the Kaplan-Meier method, we investigated the patency rate of arteriovenous fistula (AVF) in cases of successful PTA. We also compared PTA patency rates in cases with and without peripheral venous rupture. Venous rupture occurred in 38 cephalic, 16 brachial, and 9 basilic veins. In 63 patients, bleeding stopped and in 54 (85.7 %) of thee, PTA was successful. Among the nine failed cases, dilatation was incomplete in five, though bleeding had stopped. In patients with brachial and cephalic vein rupture the venous tract at the rupture site was not located. Two patients underwent surgery: one of these experienced brachial venous rupture, with incontrollable bleeding, and the other had nerve compression symptoms due to hematoma. Among 54 patients in whom PTA was successful, the primary and secondary six-months rates for angioaccess were 47.9% and 81.2%, and the mean patency period was 6.1 and 15.8 months, respectively. In cases of non-venous rupture, the mean patency period was 9.6 months, significantly longer than in cases involving venous rupture (p=0.02). Venous rupture occurring during the PTA of hemodialytic AVF can be managed percutaneously.

  20. Alliance ruptures, impasses, and enactments: a relational perspective.

    Science.gov (United States)

    Safran, Jeremy D; Kraus, Jessica

    2014-09-01

    Alliance ruptures, impasses, and transference-countertransference enactments are inevitable in therapy. A growing body of evidence suggests that repairing ruptures in the alliance is related to positive outcome (Safran, Muran, & Eubanks-Carter, 2011). Our research program has led to the development of training methods to enhance therapists' abilities to detect and work constructively with alliance ruptures and negative therapeutic process (Safran et al., 2014). This article outlines relevant theoretical underpinnings, intervention principles, and empirical findings.

  1. MRI in flexor tendon rupture after collagenase injection

    Energy Technology Data Exchange (ETDEWEB)

    Khurana, Shruti [Lady Hardinge Medical College, New Delhi (India); Wadhwa, Vibhor [University of Arkansas for Medical Sciences, Little Rock, AR (United States); Chhabra, Avneesh [UT Southwestern Medical Center, Dallas, TX (United States); Johns Hopkins University, Baltimore, MD (United States); Amirlak, Bardia [UT Southwestern Medical Center, Dallas, TX (United States)

    2017-02-15

    Flexor tendon rupture is an unusual complication following collagenase injection to relieve contractures. These patients require a close follow-up and in the event of tendon rupture, a decision has to be made whether to repair the tendon or manage the complication conservatively. The authors report the utility of MRI in the prognostication and management of a patient with Dupuytren's contracture, who underwent collagenase injection and subsequently developed flexor digitorum profundus tendon rupture. (orig.)

  2. Kinetics of hole nucleation in biomembrane rupture

    Energy Technology Data Exchange (ETDEWEB)

    Evans, Evan [Biomedical Engineering, Boston University, Boston, MA 02215 (United States); Smith, Benjamin A, E-mail: evanse@bu.edu [Departments of Physics and Pathology, University of British Columbia, Vancouver, BC, V6T 2A6 (Canada)

    2011-09-15

    The core component of a biological membrane is a fluid-lipid bilayer held together by interfacial-hydrophobic and van der Waals interactions, which are balanced for the most part by acyl chain entropy confinement. If biomembranes are subjected to persistent tensions, an unstable (nanoscale) hole will emerge at some time to cause rupture. Because of the large energy required to create a hole, thermal activation appears to be requisite for initiating a hole and the activation energy is expected to depend significantly on mechanical tension. Although models exist for the kinetic process of hole nucleation in tense membranes, studies of membrane survival have failed to cover the ranges of tension and lifetime needed to critically examine nucleation theory. Hence, rupturing giant ({approx}20 {mu}m) membrane vesicles ultra-slowly to ultra-quickly with slow to fast ramps of tension, we demonstrate a method to directly quantify kinetic rates at which unstable holes form in fluid membranes, at the same time providing a range of kinetic rates from <0.01 to >100 s{sup -1}. Measuring lifetimes of many hundreds of vesicles, each tensed by precision control of micropipette suction, we have determined the rates of failure for vesicles made from several synthetic phospholipids plus 1:1 mixtures of phospho- and sphingo-lipids with cholesterol, all of which represent prominent constituents of eukaryotic cell membranes. Plotted on a logarithmic scale, the failure rates for vesicles are found to rise dramatically with an increase in tension. Converting the experimental profiles of kinetic rates into changes of activation energy versus tension, we show that the results closely match expressions for thermal activation derived from a combination of meso-scale theory and molecular-scale simulations of hole formation. Moreover, we demonstrate a generic approach to transform analytical fits of activation energies obtained from rupture experiments into energy landscapes characterizing the

  3. 360-degree retinectomy for severe ocular rupture

    Institute of Scientific and Technical Information of China (English)

    ZHANG Mao-nian; JIANG Cai-hui

    2005-01-01

    Objective: To investigate the effect of 360-degree retinectomy for severe ocular rupture and evaluate the related factors associated with prognosis.Methods: A retrospective analysis was performed on 28 consecutive patients, 18 men and 10 women, with severe ocular rupture admitted to the Chinese PLA General Hospital between January 1999 and January 2002. The patients' ages ranged from 16 to 58 years, mean 29.5years. All operations were performed by the first author.All patients underwent standard 3-port pars plana vitrectomy with scleral encircling buckle,endophotocoagulation, and tamponaded with silicone oil.Lensectomy were performed on 15 eyes. 360-degree retinotomy and retinectomy were performed at anterior equator on 16 eyes, and posterior equator on 12 eyes.Results: During operation, all patients were confirmed to have vitreous hemorrhage and retinal detachment, in which hemorrhagic ciliary body detachment was found in 9 eyes, suprachoroidal hemorrhage in 12 eyes,retinal twisting like flower stalk in 11 eyes, and retinal incarceration in 17 eyes. Postoperative follow-up was conducted in 26 cases, ranged from 6 months to 46 months.Retinal reattachment achieved in 20 eyes (76. 9%), in which three patients' retina was reattached after revitrectomy. The silicone oil was removed at the fourth month in 8 eyes postoperatively. Corrected visual acuity of 0.02 or more was in 14 eyes (70. 0%) among the 20patients with reattached retina. Visual acuity of 0.05 or more was in 7 eyes ( 35.0 % ), and 0.1 or more was in 3eyes. The best visual acuity was 0.3 in 1 eye.Conclusions: Retinectomy may improve the prognosis of severe ocular rupture and save the visual function of some patients.

  4. Characteristic analysis and prevention on premature convergence in genetic algorithms

    Institute of Scientific and Technical Information of China (English)

    徐宗本; 高勇

    1997-01-01

    The identification and characteristics of premature convergence in genetic algorithms (GAs) are investigated Through a detailed quantitative analysis on the search capability and the degree of population diversity, the cause of premature convergence in GAs is recognized, and attributed to the maturation effect of the GAs: The minimum schema deduced from current population, which is the largest search space of a GA, converges to a homogeneous population in probability 1 ( so the search capability of the GA decreases and premature convergence occurs). It is shown that, as quantitative features of the maturation effect, the degree of population diversity converges to zero with probability 1, and the tendency for premature convergence is inversely proportional to the population size and directly proportional to the variance of the fitness ratio of zero allele at any gene position of the current population. Based on the theoretical analysis, several strategies for preventing premature convergence are suggest

  5. [Report on threatened premature labor: etiology, management, results].

    Science.gov (United States)

    Terzibahcian, J J; Mida, M; David, E; Weber, L; Boulanger, J C; Vitse, M

    1990-12-01

    The studies on the aetiological factors of a premature delivery constitute an old fear of obstetricians and epidemiologists. However, they remain confused and the very definition of prematurity is among the first sources of confusion. There are many therapeutic methods considered as preventive. Their efficacy is debatable whilst their secondary effects are obvious. In this article, the authors report the results of a retrospective study of observations of patients who presented threats of premature labour and analyzed the epidemiological aspects, the aetiological factors and the therapeutic methods. It seems important to consider the risk factors in order to prevent premature labour. A decrease in the use of betamimetics and an increase in that of therapies said to be of replacement does not seem to be accompanied by a relative increase in the incidence of prematurity.

  6. Premature ejaculation: A clinical review for the general physician.

    Science.gov (United States)

    Chung, Eric; Gilbert, Brent; Perera, Marlon; Roberts, Matthew J

    2015-10-01

    Premature ejaculation is one of the most common sexual dysfunctions in men. Recent epidemiological studies suggest its prevalence in Australia may range from 21-31% This article will discuss the current definition of premature ejaculation from a urological perspective. It will provide an understanding of the pathogenesis of premature ejaculation, as well as assessment and management options. Premature ejaculation can have a significant adverse effect on the quality of life for the patient and his sexual partners. It can potentially lead to psychological distress, diminished self- esteem, anxiety, erectile dysfunction, reduced libido and poor interpersonal relationships. Most men feel reluctant to discuss premature ejaculation with their general practitioner despite its psychological, emotional and relational effects. Effective, evidence-based treatment options are available and physicians should feel confident when exploring ways to improve the quality of life for men with sexual dysfunction.

  7. Hypothyroxinemia of prematurity: rite of passage or therapeutic necessity?

    Science.gov (United States)

    Beeram, M R; Wilson, D P

    2000-11-01

    Hypothyroxinemia is a common finding in premature infants, presumably resulting from an immature hypothalamic-pituitary-thyroid axis. Because dynamic studies of thyroid function in premature infants are normal and the condition resolves spontaneously, HOP has been considered physiologic rather than pathologic. Thus, thyroid hormone supplementation has been assumed to be not required in premature infants. True hypothyroidism of hypothalamic pituitary or thyroid origin, however, does occur in premature as well as in term infants and should be investigated aggressively and treated appropriately. Current studies in premature infants with hypothyroxinemia suggest the following: infants with more than 27 weeks of gestation do not appear to benefit and may, in fact, be harmed by thyroid hormone supplementation; and short-term thyroid hormone supplementation in infants born before 27 weeks of gestation may be important to diminish morbidity and to improve neurodevelopmental outcome.

  8. Bladder rupture causing pseudo acute renal failure

    Directory of Open Access Journals (Sweden)

    Luciana Andrea Avena Smeili

    2011-09-01

    Full Text Available Bladder rupture is a rare condition associated with significant morbidityand mortality. It is classified into traumatic, nontraumatic or idiopathic andspontaneous. The nonspecific initial clinical presentation is followed bydiscomfort in the lower abdomen, oliguria, hematuria and ascitis. Laboratoryabnormalities simulate the picture of acute renal failure and occurs by amechanism called auto reverse dialysis, with absorption of excreta throughthe peritoneal membrane. The authors describe a case of bladder rupturein morphologically and functionally normal urinary bladder associated withalcohol intake in young healthy man, manifested by abdominal discomfort,pseudo renal failure and massive ascitis. The diagnosis was made by anabdominal multidetector computed tomography confirmed by the finding of7 cm laceration at laparotomy.

  9. Insight on pathogenesis of lifelong premature ejaculation: inverse relationship between lifelong premature ejaculation and obesity.

    Science.gov (United States)

    Gökçe, A; Ekmekcioglu, O

    2010-01-01

    Although both biological and psychological factors are important in the etiology, the exact pathogenesis of lifelong premature ejaculation (PE) remains to be clarified. Obesity is a worldwide epidemic that contributes to many chronic diseases. Obesity is associated with erectile dysfunction, but the relationship between obesity and PE has not yet been specifically investigated. The aim of this study was to evaluate the relationships of these two conditions. Between January 2008 and December 2009, we evaluated consecutive patients with lifelong PE in the urology outpatient clinic. Control cases without lifelong PE were selected randomly among cases attending the department of internal medicine for a checkup procedure. The age and sex of control group were matched with that of the study group. Body mass index (BMI) of each case was calculated using the World Health Organization criteria by the measurements of the physician instead of relying on verbal expressions. The mean (+/-s.d.) age of the premature ejaculators was 31.7+/-5.7 (range 21-51) years and in the control cases it was 32.3+/-6.7 (range 22-54) years. The comparison of the mean (+/-s.d.) weight between the study (74.1+/-11.2 kg) and control groups (81.9+/-6.4 kg) revealed a significant difference (Pobese cases in the control group (n=26, 24.1%) was three times greater than the obese premature ejaculators (Pobesity, and we found that patients with lifelong PE were leaner than the healthy control cases.

  10. Closed proximal muscle rupture of the biceps brachii in wakeboarders.

    Science.gov (United States)

    Pascual-Garrido, Cecilia; Swanson, Britta L; Bannar, Stephen M

    2012-06-01

    Closed proximal muscle rupture of the biceps brachii is a rare injury. In this report, two cases of closed proximal muscle rupture of the biceps brachii after wakeboard traumas are described. Both patients presented with a swollen arm, weakness during flexion, and a mass in the affected forearm. Magnetic resonance imaging showed displacement of the biceps brachii into the forearm. The rupture was successfully treated with muscle removal in one case and muscle repair in the other. In patients with a wakeboard trauma and similar presentations, closed proximal muscle rupture of the biceps brachii should be suspected.

  11. Thrombosis and morphology of plaque rupture using optical coherence tomography

    Institute of Scientific and Technical Information of China (English)

    GUO Jun; CHEN Yun-dai; TIAN Feng; LIU Hong-bin; CHEN Lian; SUN Zhi-jun; REN Yi-hong

    2013-01-01

    Background Thrombosis following plaque rupture is the main cause of acute coronary syndrome,but not all plaque ruptures lead to thrombosis.There are limited in vivo data on the relationship between the morphology of ruptured plaque and thrombosis.Methods We used optical coherence tomography (OCT) to investigate the morphology of plaque rupture and its relation to coronary artery thrombosis in patients with coronary heart disease.Forty-two patients with coronary artery plaque rupture detected by OCT were divided into two groups (with or without thrombus) and the morphological characteristics of ruptured plaque,including fibrous cap thickness and broken cap site,were recorded.Results The fibrous cap of ruptured plaque with thrombus was significantly thinner compared to caps without thrombus ((57.00±17.00) μm vs.(96.00±48.00) μm; P=0.0076).Conclusions Plaque rupture associated with thrombosis occurs primarily in plaque covered by a thin fibrous cap.Thick fibrous caps are associated with greater stability of ruptured plaque.

  12. Risk factors affecting chronic rupture of the plantar fascia.

    Science.gov (United States)

    Lee, Ho Seong; Choi, Young Rak; Kim, Sang Woo; Lee, Jin Yong; Seo, Jeong Ho; Jeong, Jae Jung

    2014-03-01

    Prior to 1994, plantar fascia ruptures were considered as an acute injury that occurred primarily in athletes. However, plantar fascia ruptures have recently been reported in the setting of preexisting plantar fasciitis. We analyzed risk factors causing plantar fascia rupture in the presence of preexisting plantar fasciitis. We retrospectively reviewed 286 patients with plantar fasciitis who were referred from private clinics between March 2004 and February 2008. Patients were divided into those with or without a plantar fascia rupture. There were 35 patients in the rupture group and 251 in the nonrupture group. The clinical characteristics and risk factors for plantar fascia rupture were compared between the 2 groups. We compared age, gender, the affected site, visual analog scale pain score, previous treatment regimen, body mass index, degree of ankle dorsiflexion, the use of steroid injections, the extent of activity, calcaneal pitch angle, the presence of a calcaneal spur, and heel alignment between the 2 groups. Of the assessed risk factors, only steroid injection was associated with the occurrence of a plantar fascia rupture. Among the 35 patients with a rupture, 33 had received steroid injections. The odds ratio of steroid injection was 33. Steroid injections for plantar fasciitis should be cautiously administered because of the higher risk for plantar fascia rupture. Level III, retrospective comparative study.

  13. Rupture Process During the 2015 Illapel, Chile Earthquake: Zigzag-Along-Dip Rupture Episodes

    Science.gov (United States)

    Okuwaki, Ryo; Yagi, Yuji; Aránguiz, Rafael; González, Juan; González, Gabriel

    2016-04-01

    We constructed a seismic source model for the 2015 M W 8.3 Illapel, Chile earthquake, which was carried out with the kinematic waveform inversion method adopting a novel inversion formulation that takes into account the uncertainty in the Green's function, together with the hybrid backprojection method enabling us to track the spatiotemporal distribution of high-frequency (0.3-2.0 Hz) sources at high resolution by using globally observed teleseismic P-waveforms. A maximum slip amounted to 10.4 m in the shallow part of the seismic source region centered 72 km northwest of the epicenter and generated a following tsunami inundated along the coast. In a gross sense, the rupture front propagated almost unilaterally to northward from the hypocenter at event at the down-dip edge of the seismic source region. High-frequency sources tends to be distributed at deeper parts of the slip area, a pattern also documented in other subduction zone megathrust earthquakes that may reflect the heterogeneous distribution of fracture energy or stress drop along the fault. The weak excitation of high-frequency radiation at the termination of rupture may represent the gradual deceleration of rupture velocity at the transition zone of frictional property or stress state between the megathrust rupture zone and the swarm area.

  14. Mode of delivery and neurosonographic findings in premature infants

    Directory of Open Access Journals (Sweden)

    Velisavljev-Filipović Gordana

    2007-01-01

    Full Text Available Introduction Fetal and preterm infant brain is especially vulnerable to hemorrhagic and ischemic damage at the end of the second and at the beginning of the third trimester. This is due to vascular, cellular and anatomic characteristics of the brain during development. In premature babies, there is a physiological instability and limited autoregulation of cerebral circulation. Hemorrhagic and ischemic damages often occur together, though pathophysiological processes leading to lesions are different. Material and methods The paper deals with a detailed analysis of 860 ultrasound brain scans of prematurely born children. The examinations were performed at the Ultrasound Department of the Institute of Child and Youth Health Care in Novi Sad. 707 vaginally born premature infants and 153 premature infants born by Cesarean section were examined. The bleeding was graded according to the Papile classification. Results and Discussion Out of 384 children with diagnosed grade I hemorrhage, 75 premature infants (19.5% were born by Cesarean section. In the group of children with grade II hemorrhage, operative deliveries account for 14.7%. From the total of 85 children with grade III hemorrhage, (intraventricular bleeding with chamber dilatation, only 6 premature infants were born by Cesarean section (7%. Intra-parenchymal bleeding was diagnosed in a very small number of premature infants; 0.32% of all diagnosed hemorrhages were grade IV hemorrhages. In this group there were no children born by Cesarean section. The increase of hemorrhage grade is accompanied by a greater rate of pelvic presentation and manual assistance by Bracht. There were 240 prematurely born children with no echosonographically diagnosed hemorrhage, 38% of all examined premature infants. From this number, 13.3% of neonates were born by Cesarean section. Conclusion In the etiology of neonatal intracranial hemorrhage, especially prematurely born ones, apart from the trauma, which plays a

  15. Application of actuator-driven pulsed water jet in aneurysmal subarachnoid hemorrhage surgery: its effectiveness for dissection around ruptured aneurysmal walls and subarachnoid clot removal.

    Science.gov (United States)

    Endo, Hidenori; Endo, Toshiki; Nakagawa, Atsuhiro; Fujimura, Miki; Tominaga, Teiji

    2017-07-01

    In clipping surgery for aneurysmal subarachnoid hemorrhage (aSAH), critical steps include clot removal and dissection of aneurysms without premature rupture or brain injuries. To pursue this goal, a piezo actuator-driven pulsed water jet (ADPJ) system was introduced in this study. This study included 42 patients, who suffered aSAH and underwent clipping surgery. Eleven patients underwent surgery with the assistance of the ADPJ system (ADPJ group). In the other 31 patients, surgery was performed without the ADPJ system (Control group). The ADPJ system was used for clot removal and aneurysmal dissection. The clinical impact of the ADPJ system was judged by comparing the rate of premature rupture, degree of clot removal, and clinical outcomes. Intraoperatively, a premature rupture was encountered in 18.2 and 25.8% of cases in the ADPJ and control groups, respectively. Although the differences were not statistically significant, intraoperative observation suggested that the ADPJ system was effective in clot removal and dissection of aneurysms in a safe manner. Computed tomography scans indicated the achievement of higher degrees of clot removal, especially when the ADPJ system was used for cases with preoperative clot volumes of more than 25 ml (p = 0.047, Mann-Whitney U test). Clinical outcomes, including incidence of postoperative brain injury or symptomatic vasospasm, were similar in both groups. We described our preliminary surgical results using the ADPJ system for aSAH. Although further study is needed, the ADPJ system was considered a safe and effective tool for clot removal and dissection of aneurysms.

  16. Long-term results after repair of ruptured and non-ruptured abdominal aortic aneurysm

    Directory of Open Access Journals (Sweden)

    Kuzmanović Ilija B.

    2004-01-01

    Full Text Available INTRODUCTION Abdominal aortic aneurysm can be repaired by elective procedure while asymptomatic, or immediately when it is complicated - mostly due to rupture. Treating abdominal aneurysm electively, before it becomes urgent, has medical and economical reason. Today, the first month mortality after elective operations of the abdominal aorta aneurysm is less than 3%; on the other hand, significant mortality (25%-70% has been recorded in patients operated immediately because of rupture of the abdominal aneurysm. In addition, the costs of elective surgical treatment are significantly lower. OBJECTIVE The objective of this study is to compare long-term survival of patients that underwent elective or immediate repair of abdominal aortic aneurysm (due to rupture, and to find out the factors influencing the long-term survival of these patients. MATERIAL AND METHODS Through retrospective review of prospectively collected data of the Institute for Cardiovascular Diseases of Clinical Center of Serbia, Belgrade, 56 patients that had elective surgery and 35 patients that underwent urgent operation due to rupture of abdominal aneurysm were followed up. Only the patients that survived 30 postoperative days were included in this review, and were followed up (ranging from 2 to 126 months. Electively operated patients were followed during 58.82 months on the average (range 7 to 122, and urgently operated were followed over 52.26 months (range 2 to 126. There was no significant difference of the length of postoperative follow-up between these two groups. RESULTS During this period, out of electively operated and immediately operated patients, 27 and 22 cases died, respectively. There was no significant difference (p>0,05a of long-term survival between these two groups. Obesity and early postoperative complications significantly decreased long-term survival of both electively and immediately operated patients. Graft infection, ventral hernia, aneurysm of

  17. Earthquake behavior of variable rupture- scale on active faults and application of the cascade-rupturing model

    Institute of Scientific and Technical Information of China (English)

    闻学泽

    2001-01-01

    This study reveals preliminarily the earthquake behavior of variable rupture-scale on active faults of the Chinese mainland, that is that on an individual fault portion earthquake¢s rupture-scale varies cycle to cycle, and hence earthquake¢s strength changes with time. The tendency of this variation has no necessity. On defining relative size of rupture scales, a statistical result shows that it is of the lowest probability that ruptures with the same scale occur in two successive cycles. While the rupture¢s scale in the preceding cycle is 2small2, the probability of the follow-ing rupture¢s scale being 2large2 is as many as 0.48. While the rupture¢s scale in the preceding cycle is 2middle2, the probability of the succeeding rupture being 2small2 or 2large2 scale is 0.69 or 0.25. While the rupture¢s scale in the preceding cycle is 2large2, the probability must be zero for the following rupture with 2large2 scale, and is 0.36 or 0.64 for the following rupture with 2small2 or 2middle2 scale. The author introduces and improves the cascade-rupturing model, and uses it to describe the variability and complexity of rupture scale on individual fault portions. Basic features of some active strike-slip faults on which cascade ruptures have occurred are summarized. Basing on these features the author proposes principles of cascade-rupture segmentation for this type of faults. As an ex-ample to application, the author segments one portion of the Anninghe fault zone, western Sichuan, for its future cascade rupture, and further assesses the probable strength and its corresponding probability of the coming earth-quake.

  18. Ruptures of the distal biceps tendon.

    Science.gov (United States)

    Ward, James P; Shreve, Mark C; Youm, Thomas; Strauss, Eric J

    2014-01-01

    Distal biceps ruptures occur most commonly in middle-aged males and result from eccentric contraction of the biceps tendon. The injury typically presents with pain and a tearing sensation in the antecubital fossa with resultant weakness in flexion and supination strength. Physical exam maneuvers and diagnostic imaging aid in determining the diagnosis. Nonoperative management is reserved for elderly, low demand patients, while operative intervention is generally pursued for younger patients and can consist of nonanatomic repair to the brachialis or anatomic repair to the radial tuberosity. Anatomic repair through a one-incision or two-incision approach is commonplace, while the nonanatomic repairs are rarely performed. No clear advantage exists in operative management with a one-incision versus two-incision techniques. Chronic ruptures present a more difficult situation, and allograft augmentation is often necessary. Common complications after repair include transient nerve palsy, which often resolves, and heterotopic ossification. Despite these possible complications, most studies suggest that better patient outcomes are obtained with operative, anatomic reattachment of the distal biceps tendon.

  19. The Reasons of Steam Pipeline Elbow Rupture

    Directory of Open Access Journals (Sweden)

    Mesjasz A.

    2016-09-01

    Full Text Available In the paper the reasons for steam pipeline’s elbow material rupture, made of steel 13CrMo4-5 (15HM that is being used in the energetics. Based on the mechanical properties in the ambient temperature (Rm, Rp0,2 and elongation A5 and in the increased temperature (Rp0,2t it was found, that the pipeline elbow’s material sampled from the ruptured area has lower Rp0,2 i Rp0,2t by around 2% than it is a requirement for 13CrMo4-5 steel in it’s base state. The damage appeared as a result of complex stress state, that substantially exceeded the admissible tensions, what was the consequence of considerable structure degradation level. As a result of the microstructure tests on HITACHI S4200 microscope, the considerable development of the creeping process associates were found. Also the advances progress of the microstructure degradation was observed, which is substantial decomposition of bainite and multiple, with varied secretion size, and in most cases forming the micro cracks chains. With the use of lateral micro sections the creeping voids were observed, that creates at some places the shrinkage porosities clusters and micro pores.

  20. Probability of rupture of multiple fault segments

    Science.gov (United States)

    Andrews, D.J.; Schwerer, E.

    2000-01-01

    Fault segments identified from geologic and historic evidence have sometimes been adopted as features limiting the likely extends of earthquake ruptures. There is no doubt that individual segments can sometimes join together to produce larger earthquakes. This work is a trial of an objective method to determine the probability of multisegment ruptures. The frequency of occurrence of events on all conjectured combinations of adjacent segments in northern California is found by fitting to both geologic slip rates and to an assumed distribution of event sizes for the region as a whole. Uncertainty in the shape of the distribution near the maximum magnitude has a large effect on the solution. Frequencies of individual events cannot be determined, but it is possible to find a set of frequencies to fit a model closely. A robust conclusion for the San Francisco Bay region is that large multisegment events occur on the San Andreas and San Gregorio faults, but single-segment events predominate on the extended Hayward and Calaveras strands of segments.

  1. Rupture of Right Ventricular Free Wall Following Ventricular Septal Rupture in Takotsubo Cardiomyopathy with Right Ventricular Involvement.

    Science.gov (United States)

    Sung, June Min; Hong, Sung Jin; Chung, In Hyun; Lee, Hye Young; Lee, Jae Hoon; Kim, Hyun Jung; Byun, Young Sup; Kim, Byung Ok; Rhee, Kun Joo

    2017-01-01

    Most patients diagnosed with takotsubo cardiomyopathies are expected to almost completely recover, and their prognosis is excellent. However, complications can occur in the acute phase. We present a case of a woman with takotsubo cardiomyopathy with right ventricular involvement who developed a rupture of the right ventricular free wall following ventricular septal rupture, as a consequence of an acute increase in right ventricular afterload by left-to-right shunt. Our case report illustrates that takotsubo cardiomyopathy can be life threatening in the acute phase. Ventricular septal rupture in biventricular takotsubo cardiomyopathy may be a harbinger of cardiac tamponade by right ventricular rupture.

  2. Spontaneous rupture of hydatid cyst due to strain-defecation

    Institute of Scientific and Technical Information of China (English)

    Koray Daş; Selim Sözen; Abdurrahman Selçuk Uzun; Ebru Menekşe; Faruk Karateke; Ilhan Bali

    2012-01-01

    We report a case of strain-induced spontaneous rupture of hydatid cyst. Hydatid cyst rupture was diagnosed in a 19-year-old girl who presented with swelling and pain in the the right upper quadrant of sudden onset after straining for defecation.

  3. Morphological predictors of posterior communicating artery aneurysms rupture

    Institute of Scientific and Technical Information of China (English)

    Nan Lv; Yibin Fang; Ying Yu; Jinyu Xu; Jianmin Liu; Qinghai Huang

    2015-01-01

    Objective:The conflicting findings of previous morphological studies on intracranial aneurysm rupture may be caused by the different locations of aneurysms. We aimed to determine the independent risk factors of aneurysm rupture by focusing on only posterior communicating artery (PcomA) aneurysms. Methods:In 89 PcomA aneurysms (58 ruptured, 31 unruptured), clinical and morphological characteristics were compared between the ruptured and unruptured groups. Multivariate logistic regression analysis was performed to determine the independent predictors for the rupture status of PcomA aneurysms. Results:In univariate analyses, the aneurysm dome size, aspect ratio, size ratio, dome‐to‐neck ratio, and inflow angle were significant parameters. With multivariate analyses, only the aneurysm dome size and inflow angle were significantly associated with the rupture status of PcomA aneurysms. Conclusions:Morphology was related with rupture of PcomA aneurysms. The aneurysm dome size and inflow angle were found to be the independent parameters characterizing the rupture status of PcomA aneurysms.

  4. Unusual Cause of Acute Abdomen—Ruptured Retroperitoneal Paraganglioma

    Directory of Open Access Journals (Sweden)

    Kwok-Kay Yau

    2008-01-01

    Full Text Available Ruptured retroperitoneal paraganglioma is a rare cause of acute abdomen. Its clinical presentation and laparoscopic features have seldom been reported in the literature. Herein, we report a case of ruptured retroperitoneal paraganglioma that presented as acute abdomen, and its subsequent management.

  5. Diverse rupture processes in the 2015 Peru deep earthquake doublet.

    Science.gov (United States)

    Ye, Lingling; Lay, Thorne; Kanamori, Hiroo; Zhan, Zhongwen; Duputel, Zacharie

    2016-06-01

    Earthquakes in deeply subducted oceanic lithosphere can involve either brittle or dissipative ruptures. On 24 November 2015, two deep (606 and 622 km) magnitude 7.5 and 7.6 earthquakes occurred 316 s and 55 km apart. The first event (E1) was a brittle rupture with a sequence of comparable-size subevents extending unilaterally ~50 km southward with a rupture speed of ~4.5 km/s. This earthquake triggered several aftershocks to the north along with the other major event (E2), which had 40% larger seismic moment and the same duration (~20 s), but much smaller rupture area and lower rupture speed than E1, indicating a more dissipative rupture. A minor energy release ~12 s after E1 near the E2 hypocenter, possibly initiated by the S wave from E1, and a clear aftershock ~165 s after E1 also near the E2 hypocenter, suggest that E2 was likely dynamically triggered. Differences in deep earthquake rupture behavior are commonly attributed to variations in thermal state between subduction zones. However, the marked difference in rupture behavior of the nearby Peru doublet events suggests that local variations of stress state and material properties significantly contribute to diverse behavior of deep earthquakes.

  6. Spontaneous rupture of a liver hemangioma. A case report.

    Science.gov (United States)

    Guillén-Paredes, María Pilar; Martínez Fernández, Josefa; Morales González, Álvaro; Pardo-García, José Luis

    2016-07-01

    Spontaneous rupture of a liver hemangioma is a very uncommon disease, but extremely seriousness because it is associated to a 75% of mortality caused by hipovolemic shock. A case of an spontaneous rupture of liver hemangioma, which was previously unknow, is presented.

  7. Hemorrhagic shock due to spontaneous rupture of adrenal pheochromocytoma

    Directory of Open Access Journals (Sweden)

    Bittencourt José A.

    2003-01-01

    Full Text Available The spontaneous rupture of an adrenal pheochromocytoma is an extremely rare event; however, it is potentially fatal. We report a case of spontaneous rupture of pheochromocytoma followed by an extensive retroperitoneal hematoma and hypovolemic shock. The correct diagnostic assessment determined the adequate surgical approach and a favorable outcome for the patient.

  8. Symbolic transfer entropy-based premature signal analysis

    Institute of Scientific and Technical Information of China (English)

    Wang Jun; Yu Zheng-Feng

    2012-01-01

    In this paper,we use symbolic transfer entropy to study the coupling strength between premature signals.Numerical experiments show that three types of signal couplings are in the same direction.Among them,normal signal coupling is the strongest,followed by that of premature ventricular contractions,and that of atrial premature beats is the weakest.The T test shows that the entropies of the three signals are distinct.Symbolic transfer entropy requires less data,can distinguish the three types of signals and has very good computational efficiency.

  9. Preventing the premature death of relationship marketing.

    Science.gov (United States)

    Fournier, S; Dobscha, S; Mick, D G

    1998-01-01

    Relationship marketing is in vogue. And why not? The new, increasingly efficient ways that companies have of understanding and responding to customers' needs and preferences seemingly allow them to build more meaningful connections with consumers than ever before. These connections promise to benefit the bottom line by reducing costs and increasing revenue. Unfortunately, a close look suggests that the relationships between companies and customers are troubled ones, at best. Companies may delight in learning more about their customers and in being able to provide features and services to please every possible palate. But customers delight in neither. In fact, customer satisfaction rates in the United States are at an all-time low, while complaints, boycotts, and other expressions of consumer discontent are on the rise. This mounting wave of unhappiness has yet to reach the bottom line. Sooner or later, however, corporate performance will suffer unless relationship marketing becomes what it is supposed to be--the epitome of customer orientation. Ironically, the very things that marketers are doing to build relationships with customers are often the things that are destroying those relationships. Relationship marketing is powerful in theory but troubled in practice. To prevent its premature death, marketers need to take the time to figure out how and why they are undermining their own best efforts, as well as how they can get things back on track.

  10. Nuclear Chk1 prevents premature mitotic entry.

    Science.gov (United States)

    Matsuyama, Makoto; Goto, Hidemasa; Kasahara, Kousuke; Kawakami, Yoshitaka; Nakanishi, Makoto; Kiyono, Tohru; Goshima, Naoki; Inagaki, Masaki

    2011-07-01

    Chk1 inhibits the premature activation of the cyclin-B1-Cdk1. However, it remains controversial whether Chk1 inhibits Cdk1 in the centrosome or in the nucleus before the G2-M transition. In this study, we examined the specificity of the mouse monoclonal anti-Chk1 antibody DCS-310, with which the centrosome was stained. Conditional Chk1 knockout in mouse embryonic fibroblasts reduced nuclear but not centrosomal staining with DCS-310. In Chk1(+/myc) human colon adenocarcinoma (DLD-1) cells, Chk1 was detected in the nucleus but not in the centrosome using an anti-Myc antibody. Through the combination of protein array and RNAi technologies, we identified Ccdc-151 as a protein that crossreacted with DCS-310 on the centrosome. Mitotic entry was delayed by expression of the Chk1 mutant that localized in the nucleus, although forced immobilization of Chk1 to the centrosome had little impact on the timing of mitotic entry. These results suggest that nuclear but not centrosomal Chk1 contributes to correct timing of mitotic entry.

  11. Progeria: a rare genetic premature ageing disorder.

    Science.gov (United States)

    Sinha, Jitendra Kumar; Ghosh, Shampa; Raghunath, Manchala

    2014-05-01

    Progeria is characterized by clinical features that mimic premature ageing. Although the mutation responsible for this syndrome has been deciphered, the mechanism of its action remains elusive. Progeria research has gained momentum particularly in the last two decades because of the possibility of revealing evidences about the ageing process in normal and other pathophysiological conditions. Various experimental models, both in vivo and in vitro, have been developed in an effort to understand the cellular and molecular basis of a number of clinically heterogeneous rare genetic disorders that come under the umbrella of progeroid syndromes (PSs). As per the latest clinical trial reports, Lonafarnib, a farnesyltranferase inhibitor, is a potent 'drug of hope' for Hutchinson-Gilford progeria syndrome (HGPS) and has been successful in facilitating weight gain and improving cardiovascular and skeletal pathologies in progeroid children. This can be considered as the dawn of a new era in progeria research and thus, an apt time to review the research developments in this area highlighting the molecular aspects, experimental models, promising drugs in trial and their implications to gain a better understanding of PSs.

  12. Progeria: A rare genetic premature ageing disorder

    Directory of Open Access Journals (Sweden)

    Jitendra Kumar Sinha

    2014-01-01

    Full Text Available Progeria is characterized by clinical features that mimic premature ageing. Although the mutation responsible for this syndrome has been deciphered, the mechanism of its action remains elusive. Progeria research has gained momentum particularly in the last two decades because of the possibility of revealing evidences about the ageing process in normal and other pathophysiological conditions. Various experimental models, both in vivo and in vitro, have been developed in an effort to understand the cellular and molecular basis of a number of clinically heterogeneous rare genetic disorders that come under the umbrella of progeroid syndromes (PSs. As per the latest clinical trial reports, Lonafarnib, a farnesyltranferase inhibitor, is a potent ′drug of hope′ for Hutchinson-Gilford progeria syndrome (HGPS and has been successful in facilitating weight gain and improving cardiovascular and skeletal pathologies in progeroid children. This can be considered as the dawn of a new era in progeria research and thus, an apt time to review the research developments in this area highlighting the molecular aspects, experimental models, promising drugs in trial and their implications to gain a better understanding of PSs.

  13. Premature birth: An Enigma for the Society?

    Directory of Open Access Journals (Sweden)

    Sribas Goswami

    2014-12-01

    Full Text Available Infants born preterm are at greater risk than infants born at term for mortality and a variety of health and developmental problems. Complications include acute respiratory, gastrointestinal, immunologic, central nervous system, hearing, and vision problems, as well as longer-term motor, cognitive, visual, hearing, behavioral, social-emotional, health, and growth problems. The birth of a preterm infant can also bring considerable emotional and economic costs to families and have implications for public-sector services, such as health insurance, educational, and other social support systems. The greatest risk of mortality and morbidity is for those infants born at the earliest gestational ages. However, those infants born nearer to term represent the greatest number of infants born preterm and also experience more complications than infants born at term. Preterm birth is a complex cluster of problems with a set of overlapping factors of influence. Its causes may include individual-level behavioral and psychosocial factors, neighborhood characteristics, environmental exposures, medical conditions, infertility treatments, biological factors and genetics. Many of these factors occur in combination, particularly in those who are socioeconomically disadvantaged or who are members of racial and ethnic minority groups. The empirical investigation was carried out to draw correlation between preterm birth and eventuality. This paper deals with various issues related to the premature deliveries from socio-biological perspectives.

  14. Telomeres, telomerase and premature ovarian failure

    Directory of Open Access Journals (Sweden)

    Renata Košir Pogačnik

    2011-11-01

    Full Text Available Telomeres are specialized structures at the ends of chromosomes, consisting of six repeated nucleotides in TTAGGG sequence. Genome stability is partly maintained by the architecture of telomeres and is gradually lost as telomeres progressively shorten with each cell replication. Critically shortened telomeres are recognized by DNA repair mechanisms as DNA damage and the cell replication cycle stops. The cell eventually dies or undergoes cell apoptosis. Telomere represents a cellular marker of biological age and are therefore also called cell mitotic clock. The enzyme that counteracts telomere shortening by adding nucleotides to the 3’ end of DNA strand is called telomerase. It is composed of the RNA subunit (TR, which is special type of messenger RNA (mRNA, the catalytic protein subunit (TERT, which works as a reverse transcriptase and numerous additional proteins. Telomerase is active in some germline, epithelial and haemopoietic cells, but in most somatic cells the activity is undetectable. In literature, the length of telomeres is closely connected with premature ovarian failure (POF. POF is generally defined as the onset of menopause before the age of 40. The causes of disease are genetical, autoimmune, iatrogenic or if we cannot establish the cause – idiopathic. A lot of studies examined correlation between idiopathic POF, length of telomeres and telomerase activity. The studies mostly show that women with POF have shortened telomeres and decreased activity of telomerase as compared to healthy women.

  15. Control of seafloor roughness on earthquake rupture behavior

    Science.gov (United States)

    Bilek, Susan L.; Schwartz, Susan Y.; Deshon, Heather R.

    2003-05-01

    Earthquake rupture complexity is described for three recent large underthrusting earthquakes along the Costa Rican subduction zone, the 1983 Osa, 1990 Nicoya Gulf, and 1999 Quepos events. These earthquakes occurred in regions characterized by distinctly different morphologic features on the subducting plate. The 1990 and 1999 events occurred along linear projections of subducting seamount chains and had fairly simple earthquake rupture histories. Both events are interpreted as failure of the basal contact of closely spaced isolated seamounts acting as asperities. In contrast, the 1983 event occurred along the subducting Cocos Ridge and had a complex rupture history. Comparison of rupture characteristics of these large underthrusting earthquakes with size and location of subducting features provides evidence that seamounts can be subducted to seismogenic depths and that variations in seafloor bathymetry of the subducting plate strongly influence the earthquake rupture process.

  16. Use of fluroquinolone and risk of Achilles tendon rupture

    DEFF Research Database (Denmark)

    Sode, Jacob; Obel, Niels; Hallas, Jesper

    2007-01-01

    OBJECTIVE: Several case-control studies have reported that the use of fluoroquinolone increases the risk of rupture of the Achilles tendon. Our aim was to estimate this risk by means of a population-based cohort approach. SETTING: Data on Achilles tendon ruptures and fluoroquinolone use were...... retrieved from three population-based databases that include information on residents of Funen County (population: 470,000) in primary and secondary care during the period 1991-1999. A study cohort of all 28,262 first-time users of fluoroquinolone and all incident cases of Achilles tendon ruptures were...... identified. MAIN OUTCOME MEASURES: The incidence rate of Achilles tendon ruptures among users and non-users of fluoroquinolones and the standardised incidence rate ratio associating fluoroquinolon use with Achilles tendon rupture were the main outcome measures. RESULTS: Between 1991 and 2002 the incidence...

  17. Spontaneous rupture of multifocal hepatocellular carcinoma: case report

    Directory of Open Access Journals (Sweden)

    Özen Ö

    2015-08-01

    Full Text Available Özkan Özen, Alptekin Tosun, Çiğdem Akgül Department of Radiology, Faculty of Medicine, Giresun University, Giresun, Turkey Abstract: Hemoperitoneum due to nontraumatic liver rupture is rare. The most common cause of nontraumatic rupture of the liver is hepatocellular carcinoma (HCC. The other causes of nontraumatic liver ruptures are peliosis hepatis, polyarteritis nodosa, systemic lupus erythematosus, preeclampsia, metastatic carcinoma, and other primary liver tumors. In this report, we present the computed tomography findings of spontaneous liver rupture in a 52-year-old male patient due to multifocal HCC, with the diagnosis proven by surgical specimen. Keywords: computed tomography, hemoperitoneum, liver, nontraumatic liver rupture

  18. Incidence of plantar fascia ruptures following corticosteroid injection.

    Science.gov (United States)

    Kim, Chul; Cashdollar, Michael R; Mendicino, Robert W; Catanzariti, Alan R; Fuge, LaDonna

    2010-12-01

    Plantar fasciitis is commonly treated with corticosteroid injections to decrease pain and inflammation. Therapeutic benefits often vary in terms of efficacy and duration. Rupture of the plantar fascia has been reported as a possible complication following corticosteroid injection. A retrospective chart review of 120 patients who received corticosteroid injection for plantar fasciitis was performed at the authors' institution to determine the incidence of plantar fascia rupture. The plantar fascia rupture was diagnosed clinically and confirmed with magnetic resonance imaging. Various factors were analyzed, including the number of injections, interval between injections, body mass index (BMI), and activity level. Four patients (2.4%) consequently experienced plantar fascia rupture following an average of 2.67 injections. The average BMI of these patients was 38.6 kg/m². The authors conclude that corticosteroid injection therapy appears to be a safe and effective form of nonoperative treatment with minimal complications and a relatively low incident of plantar fascia rupture.

  19. Chest radiography in acute traumatic rupture of the thoracic aorta

    Energy Technology Data Exchange (ETDEWEB)

    Heystraten, F.M.; Rosenbusch, G.; Kingma, L.M.; Lacquet, L.K.; Boo, T. de; Lemmens, W.A.

    Of 123 patients who had suffered blunt trauma to the chest traumatic aortic rupture was eventually confirmed in 61 and absent in 62 patients. The chest radiographs of these patients were examined for 15 signs reported in the literature as being associated with traumatic aortic rupture. Although many individual signs were significantly more frequent in the aortic rupture group they were not useful in differentiating between patients with and those without rupture of the aorta. By using discriminant analysis combining 2 or 3 signs, patients were classified as having aortic rupture or not. The best discrimination between the two groups was obtained using the combined signs of a widened paratracheal stripe, and opacified pulmonary window, a widened right paraspinal interface and a displaced nasogastric tube.

  20. Malignant fibrous histiocytoma presenting as hemoperitoneum mimicking hepatocellular carcinoma rupture

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Malignant fibrous histiocytoma (MFH) is a pleomorphic mesenchynal sarcoma. It is uncommonly arises primarily from the intra-peritoneal cavity. Primary peritoneal MFH with tumor bleeding and rupture is rare. We describe the imaging features of a 70-year-old patient presenting with ruptured hemorrhagic peritoneal MFH at subhepatic area, accompanied by massive hemoperitoneum,mimicking a ruptured pedunculated hepatocellular carcinoma. Computed tomography (CT) revealed a large heterogeneous enhanced subhepatic mass with adjacent liver, gallbladder and colon invasion. Tumor hemorrhage and rupture complicated with peritoneal seeding and massive bloody ascites were also detected.Angiography showed a hypervascular tumor fed by enlarged right hepatic arteries, cystic artery and omental branches of gastroepiploic artery. The patient underwent laparotomy for tumor resection, but the tumor recurred one month after operation. To our knowledge, the CT appearance of ruptured intraperitoneal MFH complicated by hemoperitoneum has not been previously described.