AMNIOCENTESIS IN THE MANAGEMENT OF PRETERM PREMATURE RUPTURE OF THE MEMBRANES

被引：30

作者：

DUDLEY, J ^{[1
]}

MALCOLM, G ^{[1
]}

ELLWOOD, D ^{[1
]}

机构：

[1] KING GEORGE V MEM HOSP,DEPT FETAL & PERINATAL MED,SYDNEY,AUSTRALIA

来源：

AUSTRALIAN & NEW ZEALAND JOURNAL OF OBSTETRICS & GYNAECOLOGY | 1991年 / 31卷 / 04期

关键词：

D O I：

10.1111/j.1479-828X.1991.tb02814.x

中图分类号：

R71 [妇产科学];

学科分类号：

100211 ;

摘要：

A retrospective analysis has been performed of perinatal outcome in 81 pregnancies in which preterm premature rupture of membranes (PPROM) was managed using amniocentesis to diagnose intrauterine infection and lung maturity. Ten patients (13%) had a positive Gram stain on microscopy whilst 29 (37%) had a positive culture. Forty-one patients (58%) had a mature lecithin:sphingomyelin ratio. There was evidence of sepsis in 13 neonates (16%), with a further 16 (20%) being colonized. Both Gram stain and amniotic fluid culture were relatively poor predictors of neonatal sepsis. For Gram stain the sensitivity was low at only 15%. Although the sensitivity for culture was higher (69%), the specificity (71%) was too low to be clinically useful. It is recommended that a randomized controlled trial of amniocentesis in PPROM is needed to define the role of this diagnostic test.

引用

页码：331 / 336

页数：6

共 16 条

[1]

Veille JC., Management of preterm premature rupture of membranes, Clin Perinatol, 15, pp. 851-862, (1988)

[2]

Taslimi MM, Sibai BM, Amon E., Taslim CK, Herrick CN., A national survey on preterm labour, Am J Obstet Gynecol, 160, pp. 1352-1360, (1989)

[3]

Fisk NM., Modification to selective conservative management in preterm premature rupture of the membranes, Obstet Gynecol Surv, 43, pp. 328-334, (1988)

[4]

Ohlsson A., Wang E., An analysis of antenatal tests to detect infections in preterm premature rupture of the membranes, Am J Obstet Gynecol, 162, pp. 809-818, (1990)

[5]

Brockhuizen FF, Gilman M., Hamilton PR., Amniocentesis for gram stain and culture in preterm premature rupture of the membranes, Obstet Gynecol, 66, pp. 316-319, (1985)

[6]

Burke MS, Poreco RP., Use of amniotic fluid analysis in the management of preterm rupture of the membranes, J Reprod Med, 31, pp. 31-38, (1986)

[7]

Cotton DB, Hill LM, Strassner HT, Piatt LD, Ledger WJ., Use of amniocentesis in preterm gestation with ruptured membranes, Obstet Gynecol, 63, pp. 38-43, (1984)

[8]

Feinstein SJ, Vintzileos AM, Lodeiro JG, Campbell WA, Weinbaum PJ, Nochimson DJ., Amniocentesis with premature rupture of membranes, Obstet Gynecol, 68, pp. 147-152, (1986)

[9]

Garite TJ, Freeman RK, Linzey EM, Braly P., The use of amniocentesis in patients with premature rupture of the membranes, Obstet Gynecol, 54, pp. 1266-1269, (1979)

[10]

Vintzileos AM, Campbell WA, Nochimson DJ, Weinbaum, Escoto DT, Mirochnick MH., Qualitative amniotic fluid volume versus amniocentesis in predicting infection in preterm premature rupture of the membranes, Obstet Gynecol, 67, pp. 579-583, (1986)

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