Littérature scientifique sur le sujet « Premature rupture of fetal membranes »
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Articles de revues sur le sujet "Premature rupture of fetal membranes"
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Sefik Gokce et Dilsad Herkiloglu. « Premature rupture of membranes ». World Journal of Advanced Research and Reviews 11, no 3 (30 septembre 2021) : 363–70. http://dx.doi.org/10.30574/wjarr.2021.11.3.0393.
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Prenatal (premature) rupture of membranes (PROM) is defined as rupture of fetal membranes before the onset of labor or regular uterine contractions. PROM can lead to serious complications such as uterine cavity infection, umbilical cord compression, oligohydramnios, fetal malpresentation, umbilical cord prolapse, preterm delivery, fetal asphyxia and death. Initial evaluation of all term pregnancies with suspected PROM should include confirmation of membrane rupture and assessment of maternal and fetal well-being. Immediate initiation of labor is recommended in term pregnant women with PROM. Compared with expectant management, induction of labor is associated with a reduction in maternal and possibly neonatal infection and lower treatment costs without an increase in cesarean delivery. Induction with oxytocin is recommended. Oxytocin is as effective as prostaglandins, easier to titrate and may be less expensive depending on the preparation. Balloon catheter use is not recommended for cervical ripening in PROM.
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Azqinar, Tiara Cornela, et Agung Ikhssani. « The Role of Vitamin C in the Prevention of Premature Rupture of Membranes ». Journal of Maternal and Child Health Sciences (JMCHS) 1, no 2 (17 décembre 2021) : 51–56. http://dx.doi.org/10.36086/maternalandchild.v1i2.966.
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Premature rupture of membranes [PROM] is an early event in approximately one third of preterm births resulting in significant infant mortality and morbidity. The exact mechanism by which the fetal membranes weaken and rupture in term and preterm pregnancy is unknown. However, it has been hypothesized that the fetal membranes weaken and eventually rupture as a result of collagen remodeling and apoptosis. Some studies have speculated that vitamin C supplementation during pregnancy will be useful in the prevention of PROM but some studies have also shown that vitamin C supplementation does not affect normal fetal membrane remodeling processes leading to weakening and rupture of the fetal membranes. This literature review discusses the role of Vitamin C in the prevention of PROM, where the role of vitamin C can induce collagen degradation and apoptosis. The assumption that vitamin C supplementation may be a prophylactic regimen for premature PROM should be investigated further. Caution should be exercised in using vitamin C supplements to prevent PROM in pregnant women. This literature review discusses the role of vitamin C in preventing premature rupture of membranes.
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Fitriyani, Fitriyani. « FAKTOR DETERMINAN PADA KETUBAN PECAH DINI ». JURNAL MEDIA KESEHATAN 11, no 1 (16 novembre 2018) : 053–61. http://dx.doi.org/10.33088/jmk.v11i1.357.
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Every year the incidence of premature rupture of membranes ranges from 5-10% of all preterm preterm births and membranes occurring in 1% of all pregnancies.70% of cases of premature rupture of membranes occur in early pregnancy, prematurerupture of membranes is the cause of preterm birth as much as 30% (Manuaba, 2010). Atthe Derah Kepahiang General Hospital, the incidence of premature rupture of membranesis 219 cases in 2016.This research is analytical descriptive research with case controldesign. The sample in this study amounted to 138 people divided into two groups of 69cases and 69 controls. Statistical test using chi square test and binary logisticregression.Results of the study of 69 people with premature rupture of membranes atmaternal age <20 and> 35 years (46.4%), primiparity and grandemultipara parity(62.3%), fetal abnormalities (33.3%), gestational age aterm ( 63.8%) and those with ahistory of premature rupture (18.8%) in Kepahiang Hospital by 2016. Maternal age (pvalue0.013 OR = 2.646), parity (p-value 0.0,0 OR OR = 3.111) (p-value 0,0017 OR =2,950), gestational age (p-value 0,386) and history of premature rupture (p-value 0,167)at Kepahiang Hospital 2016. The most dominant factor causing premature rupture ofmembranes in RSUD Kepahiang year 2016 is parity (Exp (B) 2,806).It is expected thatthe hospital can use the research as input to suppress the incidence of premature ruptureof membranes, by counseling to explain the risk factors of premature rupture ofmembranes, especially maternal age, parity and fetal abnormalities.
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Banotra, Palvi, Zahoor Ahmad et Samaa Haneef. « Fetal-Maternal Complications due to Premature Rupture of Membranes : A Prospective Study at Valley’s Famous Maternity Hospital ». International Journal of Research and Review 9, no 1 (29 janvier 2022) : 610–13. http://dx.doi.org/10.52403/ijrr.20220170.
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Background: The fetal membrane remains intact till the labor starts in order to maintain the protective intrauterine fluid environment. However, sometimes membranes ruptures prematurely (PROM), a condition in which the disruption of fetal membranes takes place before the beginning of labor that ultimately results in spontaneous leakage of amniotic fluid. The present study is aimed to evaluate the feto-maternal outcomes due to premature rupture of membranes at term. Methods: A total 70 pregnant women patients with premature rupture of membranes after 37 completed weeks were selected in the study after they properly signed the consent form. Gestational age was confirmed from LMP, clinically, and radiologically. Cervical dilatation of <3 cms, Lack of uterine contractions for at least 1 hour from PROM, Single live pregnancy in vertex presentation and PROM confirmed by Direct visualization or Litmus. Results: Febrile illness as maternal outcome was found in 18.6% patients followed by wound infection in 4.3%. Rest of the patients had pph (2.9%), UTI (1.4%) and sepsis (2.9) as maternal outcome. Perinatal outcome was assessed among the studied patients and it was found that (17.1%) had birth asphyxia followed by (5.7%) patients with septicemia perinatal outcome. Only (2.9%) patients had death as perinatal outcome. Conclusion: The present study revealed that PPROM is undoubtedly associated with a prenatal morbidity and mortality. However, early diagnosis and timely management is must in order to reduce the associated complications due to PROM. Keywords: Premature rupture of membrane, perinatal complications, gestational age.
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Parry, Samuel, et Jerome F. Strauss. « Premature Rupture of the Fetal Membranes ». New England Journal of Medicine 338, no 10 (5 mars 1998) : 663–70. http://dx.doi.org/10.1056/nejm199803053381006.
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Weitz, Beth W. « PREMATURE RUPTURE OF THE FETAL MEMBRANES ». MCN, The American Journal of Maternal/Child Nursing 26, no 2 (mars 2001) : 86–92. http://dx.doi.org/10.1097/00005721-200103000-00007.
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Draper, Deborah, Ward Jones, R. Phillip Heine, Michelle Beutz, Janice I. French et James A. McGregor. « Trichomonas vaginalisWeakens Human Amniochorion in an In Vitro Model of Premature Membrane Rupture ». Infectious Diseases in Obstetrics and Gynecology 2, no 6 (1995) : 267–74. http://dx.doi.org/10.1155/s1064744995000160.
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Objective: Trichomonas vaginalis (TV)infection is associated with preterm rupture of membranes (PROM) and preterm birth. We evaluated the effects ofTVgrowth and metabolism on preparations of human amniochorion to understand and characterize howTVmay impair fetal-membrane integrity and predispose to PROM and preterm birth.Methods:Term fetal membranes were evaluated using an established in vitro fetal-membrane model. FreshTVclinical isolates were obtained from pregnant women. The protozoa (5.0×105to1.5×106/ml) were incubated with fetal membranes in modified Diamond's medium for 20 h at 37°C in 5%CO2.The effects of fetal-membrane strength (bursting tension, work to rupture, and elasticity) were measured using a calibrated Wheatstone-bridge dynamometer. Tests were also performed to evaluate the effects of 1) inoculum size; 2) metronidazole (50 μg/ml); and 3) cell-free filtrate.Results:TheTV-induced membrane effects were 1) isolate variable; 2) inoculum dependent; 3) incompletely protected by metronidazole; and 4) mediated by both live organisms as well as protozoan-free culture filtrates. Six of 9 isolates significantly reduced the calculated work to rupture (P≤ 0.02); 7 of 9 reduced bursting tension; and 1 of 9 reduced elasticity. One isolate significantly increased the work to rupture and bursting tension (P≤ 0.002).Conclusions:In vitro incubation of fetal membranes withTVcan significantly impair the measures of fetal-membrane strength. This model may be used to delineate the mechanisms ofTV-induced membrane damage. This study suggests that there are enzyme-specific effects as well as pH effects.
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Tkalich, V. O., V. V. Bila et O. S. Zahorodnya. « The prevalence of inflammatory process in placentas from premature births in different gestational periods ». Reproductive health of woman, no 5 (31 juillet 2024) : 90–94. http://dx.doi.org/10.30841/2708-8731.5.2024.310399.
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Premature birth (PB) is the birth in less than 37 weeks, which can be spontaneous and iatrogenic, its frequency reaches 10% of all births. The pathogenesis of premature labor is based on the inflammatory reaction of the chorion, amnion and decidual membrane, but the origin of the inflammatory reaction is different depending on the gestational age.The objective: to study the prevalence of the inflammatory response in placenta samples from very early preterm, early preterm and term births.Materials and methods. Placenta samples from 203 parturient women who gave birth in the gestational period of 22–27 weeks – very early PB (I group – 101 parturient women with premature rupture of membranes (PROM), II group – 102 parturient women with the onset of labor with intact membranes) and 202 parturient women were examined with deliveries in the period of 28–34 weeks – early PB (III group – 100 women in labor with PROM and IV group – 102 women in labor with the onset of labor with intact fetal membranes) and 60 women in labor with term deliveries.Immunohistochemical detection of CD8, CD3 and CD14 antigens in villi was used to assess the prevalence of the inflammatory process and compare it between groups.Results. In 56.7% of placentas from term deliveries no markers of villousitis were detected, a mild form of villousitis was found in another third of cases. In placentas of woman with the onset of labor between the 28th and 34th weeks with intact fetal membranes there were signs of villousitis in 54.9%, and its mild manifestations in 33.3%. In the case of premature rupture of the membranes, the prevalence of villousitis reached 65%, its severe forms were more often observed.On the other hand, in the groups of very early PB only 14.9 and 15.7% of placentas had no signs of vilouisitis, one in five placentas from these groups had severe focal or diffuse villousitis. In the group of early PB and intact amniotic membranes, one third of the placentas demonstrated an isolated CD3 lymphocyte marker, no antigen was detected in 47.1% of placentas, and only in every tenth placenta antigens of macrophages of fetal origin were determined. A similar distribution was found in placentas from early PB with PROM.In placentas from very early PB the highest frequency of CD14 detection was found – every second placenta contained this marker in isolation and in 22.5% – in combination with maternal lymphocyte markers. In the group of very early PB on the background of PROM placentas with a positive CD14 test dominated – 31.7% isolated and 45.5% in combination with CD3.Conclusions. 1. In placentas from premature births (PB) at 28–34 weeks, villousitis was detected in 54.9% of cases against the background of intact amniotic membranes and in 65.0% – on the background of premature rupture of the membranes, from very early PBs – in 85.1% and 83.3%, respectively. Placentas from deliveries with premature rupture of the fetal membranes more often had signs of severe villousitis – in 21% of cases at 28–34 weeks and in 20.6% at 22–27 weeks.2. In placentas from early PB, macrophage antigen of fetal origin was detected in 22% of cases in the cases of premature rupture of the fetal membranes and in 21.6% of cases of childbirth with intact membranes; these samples were dominated by infiltration by lymphocytes of maternal origin. On the other hand, placentas from very early PB and ruptured fetal membranes in 77.2% of cases contained antigen of fetal macrophages and in 71.6% of cases of onset of labor with intact membranes.Such results indicate the fetal origin of the inflammatory process in very early PB.
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Ohel, Gonen, E. Sadovsky, Y. Aboulafia, A. Simon et G. Zajicek. « Fetal Activity in Premature Rupture of Membranes ». American Journal of Perinatology 3, no 04 (octobre 1986) : 337–38. http://dx.doi.org/10.1055/s-2007-999892.
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M., Poovathi, et Yogalaksmi Yogalaksmi. « A study of perinatal outcome in preterm premature rupture of membranes ». International Journal of Reproduction, Contraception, Obstetrics and Gynecology 7, no 12 (26 novembre 2018) : 5061. http://dx.doi.org/10.18203/2320-1770.ijrcog20184967.
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Background: Preterm premature rupture of membranes is defined as rupture of fetal membrane before onset of labour at less than 37 completed weeks of gestation and after 28 weeks of gestation. Incidence ranges from 3-10% of all deliveries. Preterm premature rupture of membrane is one of the important causes of preterm birth can result inhigh perinatal morbidity and mortality. Preterm premature rupture of membranes complicates 3% of pregnancies and leads to one third of preterm birth. Preterm delivery affects one in 10 birth in USA and even greater birth in developing continues and causes 40-75% neonatal death. There are numerous risk factors for preterm premature rupture of membrane such as maternal, socioeconomic class, infection at early gestational age and associated co-morbid condition. Both mother and fetus are at greater risk of infection after preterm premature rupture of membrane.The fetal and neonatal morbidity and mortality risks are significantly affected by severity of oligohydrominos, duration of latency and gestation at preterm premature rupture of membrane. The objective is to study perinatal outcome in preterm premature rupture of membrane.Methods: This is a prospective study conducted in Mahathma Gandhi Memorial Government Hospital attached to K. A. P. V. Government Medical College, Trichy, Tamil Nadu, India. This is a tertiary health centre. This study has been conducted from January 2018 to June 2018.Results: Incidence of PPROM ranges from 3.0-10.0% of all deliveries. PPROM complicates approximately 3% of pregnancies and leads to one third of preterm birth.Conclusions: In present study most of newborn had better 5min Apgar especially late preterm group. In present study RDS was common in early preterm group and hyper bilirubinaemia common in late preterm group. In current study most of patients delivered vaginally compared to 36% of LSCS.
Thèses sur le sujet "Premature rupture of fetal membranes"
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Nooh, Randa M. S. « Maternal group B streptococcal colonization and preterm premature rupture of the fetal membranes ». Thesis, University of Ottawa (Canada), 1994. http://hdl.handle.net/10393/9609.
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The problem. Group B Streptococci (GBS) are one of the most frequent causes of life-threatening infections in newly born infants, who acquire the micro-organism while passing through the genital tracts of their asymptomatic colonized mothers. Some previous studies have suggested that maternal genital colonization by GBS is associated with preterm rupture of the fetal membranes and preterm delivery. In this thesis both a prevalence study and a historical cohort study were conducted, to investigate the prevalence of maternal GBS colonization at 28 weeks of gestation, and whether there is an association between colonization and preterm rupture of the fetal membranes. Background information. Different rates for maternal GBS colonization during pregnancy have been reported, ranging from 4.6% up to 40%. The association between maternal GBS colonization and preterm rupture of the membranes has been reported in some studies, but other studies have not supported this view, which led to differsnces in opinions and the lack of a specific conclusion. The variations in the findings of these studies may have been due to several factors, which include differences in cultured sites and phase of pregnancy at which culture was obtained, in addition to the wide variations in the definition of premature rupture of the membranes used by various authors. (Abstract shortened by UMI.)
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Febas, Bosomba Germán. « New sealing system as a surgical tecnique to avoid the iatrogenic Preterm Premature Rupture of fetal Membranes (iPPROM) ». Doctoral thesis, Universitat Ramon Llull, 2021. http://hdl.handle.net/10803/671901.
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Aquesta tesi es centra en la creació d'un sistema de segellat que permet taponar els forats de la membrana corioamniótica produïts per l'instrumental quirúrgic de mínima invasió en operacions fetals.
Actualment, amb la millora de les tècniques d'imatge per al diagnòstic fetal que s'utilitzen per fer el seguiment de l'embaràs, ha augmentat la detecció d'anomalies fetals i, per tant, també la necessitat de dur a terme intervencions quirúrgiques amb les que accedir directament al fetus de forma segura.
Ja des de fa alguns anys, per a realitzar cirurgies de la manera menys invasiva possible s'utilitza la fetoscòpia. Tècnica en la que mitjançant la inserció d'un trocar a través de la cavitat abdominal som capaços d'introduir les eines necessàries per dur a terme la cirurgia fetal corresponent. Tot i així, l'accés al fetus des d'un sol punt limita les possibilitats de la tècnica, en contraposició de si es tingués accés des de diversos punts, ja que permetria abordar al fetus des de diversos eixos.
Un dels problemes associats a les cirurgies fetals és la presència romanent de l'orifici a la membrana corioamniótica un cop s'extreu el trócar i finalitza l'operació, ja que per si sola és incapaç de regenerar-se. La permanència de l'orifici, sobretot en les primeres hores, pot causar diferents patologies. Des d’oligohidramnios, corioamnionitis, hipoplàsia pulmonar del fetus, ..., fins trencament de la membrana corioamniótica, que pot cursar amb la mort del fetus. Aquest trencament de la membrana rep el nom de Ruptura Prematura de les Membranes a Preterme per causes iatrogèniques (iPPROM) i és una de les complicacions més comuns durant l'embaràs.
L'objectiu d'aquest treball és crear un pegat que permeti el segellat d'aquests orificis i que es redueixi de manera significativa el risc de pèrdua de líquid amniòtic i el trencament de la membrana corioamniótica durant els primers dies després de la fetoscòpia.
El desenvolupament del sistema de segellat s'ha dividit en tres parts, en que els experiments, avenços i resultats s'han obtingut de forma semi-paral·lela fins a obtenir un prototip final de dispositiu mèdic: d'una banda, desenvolupar un adhesiu amb propietats bioadhesives en medi humit i que s'activa en entrar en contacte amb el propi líquid amniòtic; d'altra banda, el substrat on estarà disposat l’adhesiu, i que junts actuen com un pegat; i finalment un sistema d'inserció que permeti la col·locació d'aquest pegat de la forma més ràpida i segura possible per part de l'equip mèdic partícip en la cirurgia.Esta tesis se centra en la creación de un sistema de sellado que permite taponar los orificios de la membrana corioamniótica producidos por el instrumental quirúrgico de mínima invasión en operaciones fetales. Actualmente, con la mejora de las técnicas de imagen para el diagnóstico fetal que se utilizan para hacer el seguimiento del embarazo, ha aumentado la detección de anomalías fetales y, por lo tanto, también la necesidad de llevar a cabo intervenciones quirúrgicas con las que acceder directamente al feto de forma segura. Ya desde hace algunos años, para realizar cirugías de la manera menos invasiva posible se utiliza la fetoscopia: técnica en la que mediante la inserción de un trócar a través de la cavidad abdominal somos capaces de introducir las herramientas necesarias para llevar a cabo la cirugía fetal correspondiente. Aun así, el acceso al feto desde un solo punto limita las posibilidades de la técnica, en contraposición de si se tuviera acceso desde varios puntos, ya que permitiría abordar al feto desde varios ejes. Uno de los problemas asociados a las cirugías fetales es la presencia remanente del orificio en la membrana corioamniótica una vez se extrae el trócar y finaliza la operación, ya que por sí sola es incapaz de regenerarse. La permanencia del orificio, sobre todo en las primeras horas, puede causar diferentes patologías. Desde oligohidramnios, corioamnionitis, hipoplasia pulmonar del feto, …, hasta rotura de la membrana corioamniótica, que cursa con la muerte del feto, si éste aún no es viable. Esta rotura de la membrana recibe el nombre de Rotura Prematura de las Membranas a Pretérmino por causas iatrogénicas (iPPROM) y es una de las complicaciones más comunes durante el embarazo. El objetivo de este trabajo es crear un parche que permita el sellado de estos orificios y que se reduzca de forma significativa la pérdida de líquido amniótico y el riesgo de rotura de la membrana corioamniótica durante los primeros días tras la fetoscopia. El desarrollo del sistema de sellado se ha dividido en tres partes, cuyos experimentos, avances y resultados se han obtenido de forma semiparalela hasta obtener un prototipo final de dispositivo médico. Por un lado, el desarrollo de un adhesivo con propiedades bioadhesivas en medio húmedo y que se activa al entrar en contacto con el líquido amniótico; por otro lado, el sustrato donde de depositará el adhesivo, y que juntos actúan como un parche; y finalmente un sistema de introducción que permita la colocación de este parche de la forma más rápida y segura posible por parte del equipo médico partícipe en la cirugía.
This thesis is focused on the creation of a sealing system that blocks the orifices of the chorioamniotic membrane produced by minimally invasive surgical instruments during fetal operations. Currently, with the improvement of imaging techniques for fetal diagnosis used to monitor pregnancy, the detection of fetal anomalies has increased. In this scenario, it is essential to develop surgical procedures to directly access the fetus in a safer manner. Over the past few years, the use of fetoscopy has provided lees invasive surgical procedures. Fetoscopy is a technique in which, by inserting a trocar through the abdominal cavity, we are able to introduce the necessary instruments to perform the corresponding fetal surgery. Even so, the access to the fetus from a single point limits the possibilities of the technique, as opposed to having access from several points, since it would allow the fetus to be approached from several axes. One of the problems associated with fetal surgeries is the remaining presence of the orifice in the chorioamniotic membrane once the trocar is removed. The permanence of the orifice, especially in the first hours after surgery, can cause different pathologies: oligohydramnios, chorioamnionitis, pulmonary hypoplasia of the fetus, etc., and also the rupture of the chorioamniotic membrane, which could result in fetal death. This rupture of the membrane is called iatrogenic preterm preterm premature rupture of membranes (iPPROM) and is one of the most common complications during pregnancy. The aim of this work is to create a patch that allows the sealing of these orifices and significantly reduces the leakage of amniotic liquid and the risk of chorioamniotic membrane rupture during the first days after fetoscopy. The development of the sealing system has been divided into three parts, which experiments, advances and results have been obtained in a semi-parallel process until a final medical device was obtained: on the one hand, the development of an adhesive with bioadhesive properties in a wet environment, which is activated when it comes into contact with the amniotic fluid itself; on the other hand, the substrate where the adhesive will be placed and which acts as a patch; and finally, an insertion system that allows the placement of this patch as quickly and safely as possible by the medical team involved in the surgery.
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Ramos, Bruna Ribeiro de Andrade [UNESP]. « Polimorfismos de genes pró e anti-inflamatórios candidatos à predisposição à rotura prematura de membranas pré-termo e ao trabalho de parto pré-termo ». Universidade Estadual Paulista (UNESP), 2015. http://hdl.handle.net/11449/140224.
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000866191.pdf: 1592677 bytes, checksum: cbfcdb8a7242a22f947e68ab4cde944d (MD5)Introdução: O Trabalho de Parto Pré-Termo (TPP) e a Rotura Prematura de Membranas Pré-Termo (RPM-PT) acarretam severas complicações para o binômio materno-fetal. Entre os fatores de risco associados ao TPP e à RPM-PT, a predisposição genética vem ganhando importância. Contudo, a associação entre genes polimórficos, ancestralidade e a patogênese do TPP e da RPM-PT permanece alusiva. Objetivo: Determinar a associação entre marcadores informativos de ancestralidade (AIMs) e polimorfismos de nucleotídeo único (SNPs) dos genes da Interleucina-1 beta (IL1B), IL6, Receptor de IL6 (IL6R), Fator de Necrose Tumoral Alfa (TNFA), Receptor de TNF alpha (TNFR), IL10, Receptor Toll-like 2 (TLR2), TLR4, Metaloproteinase 9 (MMP9), Inibidor de Metaloproteinase 1 (TIMP1) e TIMP2 maternos e fetais e o TPP e a RPM-PT. Pacientes e Métodos: Foram coletados swabs bucais de gestantes com TPP e/ou RPM-PT e DE seus filhos (TPP: 137 mulheres e 88 filhos; RPM-PT: 64 mulheres e 44 filhos) atendidas no Hospital das Clínicas da Faculdade de Medicina de Botucatu, UNESP, entre os anos de 2003 e 2014. O grupo controle foi constituído por 201 mulheres que tiveram gestações resolvidas a termo e seus 201 filhos, pareadas ao grupo caso por idade materna e sexo do recém-nascido. O DNA total foi extraído dos swabs bucais e submetido à identificação de AIMs por análise de fragmentos e genotipagem de SNPs utilizando Taqman® SNP Genotyping Assays (Applied Biosystems) e Reação em Cadeia da Polimerase (PCR). O software Structure v2.3.4 foi utilizado para estimar mistura étnica materna. Teste de desequilíbrio de ligação e proporção da Hardy-Weinberg foram testados com Genepop 3.4 e haplótipos inferidos com Phase. Os dados sociodemográficos e biológicos foram comparados utilizando os testes de χ2, teste exato de Fisher, Regressão Logística, Manova, Mann-Whitney e Odds Ratio. Resultados: Nas amostras maternas, o TPP foi associado a maior...
Introduction: A genetic predisposition to Preterm Labor (PTL) and Preterm Premature Rupture of Membranes (PPROM) has been suggested; however the relevance of polymorphisms and ancestry to susceptibility to PTL and PPROM in different populations remains unclear. Objective: To evaluate the association between Ancestry Informative Markers (AIM) and Single Nucleotide Polymorphisms (SNPs) in Interleukin-1 beta (IL1B), IL6, IL6 Receptor (IL6R), Tumor Necrosis Factor Alpha (TNFA), TNF Receptor (TNFR), IL10, Toll Like Receptor 2 (TLR2), TLR4, Metalloproteinase 9 (MMP9), Tissue Inhibitors of Metalloproteinase 1 (TIMP1) and TIMP2 genes and the susceptibility to PTL and PPROM in Brazilian women. Patients and Methods: Oral swabs were collected from women with PTL and/or PPROM and their babies (PTL: 137 women and 88 babies; PPROM: 64 women and 44 babies) seen at the Botucatu Medical School's Hospital, between 2003 and 2014. Control group included 402 mother-babies pairs of term deliveries, matched to case group by age and newborn gender. After DNA extraction, AIMs were identified by fragment analysis and SNPs by Taqman® SNP Genotyping Assays (Applied Biosystems) and Polymerase Chain Reaction (PCR). The software Structure v2.3.4 was used to estimate ethnic admixture of mothers. Linkage Disequilibrium and Hardy-Weinberg proportions were tested with Genepop 3.4 and haplotypes inferred using Phase. Mann-Whitney, χ2, Fisher's exact test, Logistic Regression models, Odds Ratio and Manova were used in data analysis. Results: Regarding maternal samples, PTL was associated to European ancestry and smoking and African ancestry was protective. Regarding ancestry analysis, self-reported ethnicity only explained 20% and 15% of the global variation in African and European contributions, respectively. Fetal IL10-592 C and IL10-819 C were also associated to PTL. Maternal alleles IL10-1082 G and TLR2 A increased the risk ...
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Ramos, Bruna Ribeiro de Andrade. « Polimorfismos de genes pró e anti-inflamatórios candidatos à predisposição à rotura prematura de membranas pré-termo e ao trabalho de parto pré-termo / ». Botucatu, 2015. http://hdl.handle.net/11449/140224.
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Orientador: Márcia Guimarães da SilvaCoorientador: Steven Witkin
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Banca: Rodrigo Paupério Soares de Camargo
Banca: Gisele Alboreghetti Nair
Resumo: Introdução: O Trabalho de Parto Pré-Termo (TPP) e a Rotura Prematura de Membranas Pré-Termo (RPM-PT) acarretam severas complicações para o binômio materno-fetal. Entre os fatores de risco associados ao TPP e à RPM-PT, a predisposição genética vem ganhando importância. Contudo, a associação entre genes polimórficos, ancestralidade e a patogênese do TPP e da RPM-PT permanece alusiva. Objetivo: Determinar a associação entre marcadores informativos de ancestralidade (AIMs) e polimorfismos de nucleotídeo único (SNPs) dos genes da Interleucina-1 beta (IL1B), IL6, Receptor de IL6 (IL6R), Fator de Necrose Tumoral Alfa (TNFA), Receptor de TNF alpha (TNFR), IL10, Receptor Toll-like 2 (TLR2), TLR4, Metaloproteinase 9 (MMP9), Inibidor de Metaloproteinase 1 (TIMP1) e TIMP2 maternos e fetais e o TPP e a RPM-PT. Pacientes e Métodos: Foram coletados swabs bucais de gestantes com TPP e/ou RPM-PT e DE seus filhos (TPP: 137 mulheres e 88 filhos; RPM-PT: 64 mulheres e 44 filhos) atendidas no Hospital das Clínicas da Faculdade de Medicina de Botucatu, UNESP, entre os anos de 2003 e 2014. O grupo controle foi constituído por 201 mulheres que tiveram gestações resolvidas a termo e seus 201 filhos, pareadas ao grupo caso por idade materna e sexo do recém-nascido. O DNA total foi extraído dos swabs bucais e submetido à identificação de AIMs por análise de fragmentos e genotipagem de SNPs utilizando Taqman® SNP Genotyping Assays (Applied Biosystems) e Reação em Cadeia da Polimerase (PCR). O software Structure v2.3.4 foi utilizado para estimar mistura étnica materna. Teste de desequilíbrio de ligação e proporção da Hardy-Weinberg foram testados com Genepop 3.4 e haplótipos inferidos com Phase. Os dados sociodemográficos e biológicos foram comparados utilizando os testes de χ2, teste exato de Fisher, Regressão Logística, Manova, Mann-Whitney e Odds Ratio. Resultados: Nas amostras maternas, o TPP foi associado a maior...
Abstract: Introduction: A genetic predisposition to Preterm Labor (PTL) and Preterm Premature Rupture of Membranes (PPROM) has been suggested; however the relevance of polymorphisms and ancestry to susceptibility to PTL and PPROM in different populations remains unclear. Objective: To evaluate the association between Ancestry Informative Markers (AIM) and Single Nucleotide Polymorphisms (SNPs) in Interleukin-1 beta (IL1B), IL6, IL6 Receptor (IL6R), Tumor Necrosis Factor Alpha (TNFA), TNF Receptor (TNFR), IL10, Toll Like Receptor 2 (TLR2), TLR4, Metalloproteinase 9 (MMP9), Tissue Inhibitors of Metalloproteinase 1 (TIMP1) and TIMP2 genes and the susceptibility to PTL and PPROM in Brazilian women. Patients and Methods: Oral swabs were collected from women with PTL and/or PPROM and their babies (PTL: 137 women and 88 babies; PPROM: 64 women and 44 babies) seen at the Botucatu Medical School's Hospital, between 2003 and 2014. Control group included 402 mother-babies pairs of term deliveries, matched to case group by age and newborn gender. After DNA extraction, AIMs were identified by fragment analysis and SNPs by Taqman® SNP Genotyping Assays (Applied Biosystems) and Polymerase Chain Reaction (PCR). The software Structure v2.3.4 was used to estimate ethnic admixture of mothers. Linkage Disequilibrium and Hardy-Weinberg proportions were tested with Genepop 3.4 and haplotypes inferred using Phase. Mann-Whitney, χ2, Fisher's exact test, Logistic Regression models, Odds Ratio and Manova were used in data analysis. Results: Regarding maternal samples, PTL was associated to European ancestry and smoking and African ancestry was protective. Regarding ancestry analysis, self-reported ethnicity only explained 20% and 15% of the global variation in African and European contributions, respectively. Fetal IL10-592 C and IL10-819 C were also associated to PTL. Maternal alleles IL10-1082 G and TLR2 A increased the risk ...
Doutor
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Vogt, Marianna. « Doença periodontal e resultados perinatais adversos em uma coorte de gestantes ». [s.n.], 2006. http://repositorio.unicamp.br/jspui/handle/REPOSIP/290423.
Texte intégralRésumé :
Orientadores: Antonio Wilson Sallum, Jose Guilherme CecattiDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba
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Resumo: Este estudo teve por objetivo avaliar a prevalência de doença periodontal em uma amostra de gestantes de baixo risco gestacional, os fatores a ela associados, e sua correlação com a ocorrência de resultados perinatais adversos, como parto pré-termo, recém-nascido de baixo peso, recém-nascido pequeno para a idade gestacional e amniorrexe prematura. Trata-se de um estudo de coorte com 334 gestantes fazendo acompanhamento pré-natal no Hospital das Clínicas da UNICAMP, que aceitaram participar voluntariamente e tiveram um único exame periodontal realizado no dia da consulta pré-natal. Os dados foram coletados da anamnese, do exame clínico periodontal e de informações relativas à gestação, parto e puerpério. Os parâmetros clínicos periodontais foram: índice de placa, índice de sangramento gengival à sondagem, profundidade de sondagem, nível de inserção clínica periodontal e retração gengival. As gestantes foram divididas em dois grupos: as com periodontite moderada a grave (P2-P4), e as sem doença ou com doença periodontal leve (P0-P1), pela classificação do índice WS. Avaliaram-se também a idade, paridade, raça, escolaridade, estado civil, hábitos alimentares, índice de massa corpórea (IMC), número de consultas de pré-natal, fumo, uso de bebidas e drogas, uso de medicação, vaginose bacteriana e doenças sistêmicas. Inicialmente foi utilizada uma abordagem analítica de corte transversal para a identificação de fatores associados à ocorrência de doença periodontal na gestação. Depois utilizou-se uma abordagem de estudo de coorte propriamente dito, estimando-se o risco de ocorrência dos resultados perinatais desfavoráveis (parto pré-termo, recém-nascido de baixo peso, recém-nascido pequeno para a idade gestacional e amniorrexe prematura, variáveis dependentes principais do estudo) em função da condição periodontal. Foram analisadas as distribuições de freqüência das variáveis independentes pelas categorias de doença periodontal, estimando-se a Razão de Prevalência e seu IC95% para abordagem transversal. Foi então realizada a análise uni e multivariada para a estimativa do risco de ocorrência das variáveis perinatais desfavoráveis na abordagem de coorte, calculando-se a Razão de Risco e seu IC95% para cada uma delas. Foi estabelecido o nível de significância de 5%. A prevalência de periodontite moderada a grave nas 334 gestantes foi de 47%, e se associou significativamente com a idade gestacional mais avançada ao exame periodontal (17-24 semanas: RP 1,40, IC95% 1,01-1,94; e 25-32 semanas: RP 1,52, IC95% 1,10-2,08), com a idade materna entre 25 e 29 anos (RP 1,65, IC95% 1,02-2,68), com a obesidade (RP 1,38, IC95% 1,04-1,82) e com a presença de sangramento gengival (ORajustado 2,01 - IC95% 1,41-2,88). Foram coletados os dados do parto de 327 gestantes e, entre elas, a doença periodontal esteve associada a um maior risco de ocorrência de parto pré-termo (RR 3,47 IC95% 1,62-7,43), de RN de baixo peso (RR 2,93 IC95% 1,36-6,34) e de amniorrexe prematura (RR 2,48 IC95% 1,35-4,56) na análise multivariada. A prevalência de doença periodontal entre gestantes de baixo risco gestacional é alta e associada com a maior idade gestacional, obesidade e sangramento gengival. A doença periodontal foi um fator de risco para a ocorrência de parto pré-termo, RN de baixo peso e de amniorrexe prematura
Abstract: This study was aimed to evaluate the prevalence of periodontal disease in a sample population of low-risk pregnant women, the factors associated with it and its correlation with the occurrence of adverse perinatal outcomes, including preterm births, low birth weigth, small for gestational age babies and premature rupture of the membranes. This cohort study included 334 pregnant women under prenatal care at the Hospital das Clinicas of the University of Campinas, Brazil, who voluntarily accepted to participate and had one single periodontal examination performed in the same day of a prenatal visit. Data was collected from anamnesis, periodontal clinical exam, and from information regarding pregnancy, delivery and postpartum. The clinical periodontal parameters were: plaque index, bleeding on probing index, probing pocket depth, clinical attachment level and gingival recession. Pregnant women were divided into two groups: those with moderate-to-severe periodontitis (P2-P4) and those with no disease or only mild disease (P0-P1), according to the WS classification index. Age, parity, race/color, years of schooling, marital status, number of prenatal visits, dietary habits, BMI (body mass index), smoking habits, use of alcohol and drugs, use of medication and presence of systemic diseases d bacterial vaginosis were also evaluated. Initially a cross sectional analytic approach was used for identifying factors associated with the occurrence of periodontal disease during pregnancy. After that, a real cohort approach was used, with the estimate of the risk of adverse perinatal outcomes (preterm birth, low birth weight, small for gestational age baby and premature rupture of membranes, the main dependent variables of this study) according to the condition of periodontal disease. Distribution of independent variables within the two groups was analyzed by calculating prevalence ratios and their respective 95% confidence intervals for the cross sectional approach. Uni and multivariate analysis for the estimation of the risk of adverse perinatal outcomes were performed for the cohort approach. The Risk Ratior and its 95%CI were estimated for each outcome. The significance level assumed was 5%. The prevalence of moderate to severe periodontitis in 334 pregnant women was 47%, and it was significantly associated with more advanced gestational age at periodontal examination (17-24 weeks: PR 1.40, 95%CI 1.01-1.94; and 25-32 weeks: PR 1.52, 95%CI 1.10 ¿ 2.08), with maternal age between 25 - 29 years (PR 1.65, 95%CI 1.02 ¿ 2.68), with obesity (PR 1.38, 95%CI 1.04 ¿ 1.82) and with the presence of gingival bleeding (ORadjusted 2.01, 95%CI 1.41 ¿ 2.88). The data of 327 deliveries were collected and, among them, the periodontal disease was associated to a higher risk of preterm birth (RR 3.47 95%CI 1.62-7.43), of low birth weight (RR 2.93 95%CI 1.36-6.34) and of premature rupture of membranes (RR 2.48 95%CI 1.35-4.56) in the multivariate analysis. The prevalence of periodontal disease among low-risk pregnant women is high and it is associated with more advanced gestational age, obesity and gingival bleeding. Periodontal disease was a risk factor for the occurrence of preterm birth, low birth weight and premature rupture of membranes
Mestrado
Periodontia
Mestre em Clínica Odontológica
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Charnay, Coline. « Implications des polluants environnementaux de type phtalates et plastifiants alternatifs lors de la rupture prématurée des membranes fœtales ». Electronic Thesis or Diss., Université Clermont Auvergne (2021-...), 2024. http://www.theses.fr/2024UCFA0192.
Texte intégralRésumé :
Les phtalates sont des composés chimiques utilisés depuis des décennies comme plastifiants dans de nombreux produits du quotidien, notamment les emballages alimentaires, les jouets et les dispositifs médicaux. Toutefois, ces substances sont également reconnues comme des perturbateurs endocriniens, avec des effets potentiellement néfastes sur la santé humaine, en particulier sur la reproduction. Leur lien avec des complications telles que les naissances prématurées et les troubles du développement fœtal a suscité une forte inquiétude. En réponse à cette situation, des plastifiants alternatifs, comme le DINCH (1,2-cyclohexanedicarboxylic acid diisononyl ester), ont été développés pour remplacer les phtalates. Cependant, les impacts à long terme de ces alternatives sur la santé, notamment sur les membranes fœtales, restent à élucider.Le DINCH est aujourd'hui utilisé dans des produits ciblant des populations sensibles, comme les femmes enceintes et les nourrissons. Bien qu'ils soient considérés comme des substances prometteuses, il subsiste un manque de données suffisantes pour garantir leur innocuité, en particulier concernant leur impact potentiel sur la grossesse. Parmi les complications liées à la grossesse, la rupture prématurée des membranes fœtales (PPROM) constitue un facteur majeur de naissances prématurées, touchant environ 3 % à 4 % des grossesses et contribuant pour 50 % des accouchements prématurés. Le rôle que pourrait jouer les plastifiants, qu'ils soient phtalates ou non, dans la survenue de cette pathologie est encore peu étudié.Ce travail de thèse se concentre sur l'exploration des effets de ces plastifiants non-phtalates, et plus particulièrement du DINCH et son métabolite le MINCH (1,2-cyclohexanedicarboxylic acid mono-4-méthyloctyl ester) sur la physiologie des membranes fœtales humaines. Plus précisément, l'étude se penche sur l'impact de ces substances sur le récepteur nucléaire PPARγ, un acteur crucial dans le maintien de la grossesse et la régulation des processus inflammatoires. PPARγ joue un rôle central dans le développement placentaire et la protection contre l'inflammation, deux éléments essentiels pour le bon déroulement de la grossesse. L'objectif principal de ce travail est d'évaluer si ces plastifiants alternatifs perturbent cette voie de signalisation et pourraient, ainsi, compromettre l'intégrité des membranes fœtales, favorisant alors leur rupture prématurée.Les expériences ont été réalisées sur un modèle de cellules épithéliales amniotiques humaines pour explorer la toxicité potentielle des plastifiants, ainsi que leurs effets sur l'expression et l'activité de PPARγ. Les résultats indiquent que le DINCH et son métabolite MINCH n'entraînent pas de perturbations majeures de l'activité de PPARγ contrairement à certains phtalates.En conclusion, cette étude ouvre la voie à une meilleure compréhension des risques potentiels des plastifiants non-phtalates sur la santé reproductive. Bien que les résultats obtenus semblent encourageants quant à l'innocuité du DINCH et du MINCH, il est crucial de mener des études complémentaires pour s'assurer de leur sécurité à long terme, notamment en ce qui concerne la prévention de la rupture prématurée des membranes fœtales et des naissances prématurées qui en résultent. Il soulève également l'importance d'informer les femmes enceintes sur les risques potentiels liés à l'exposition aux plastifiants, qu'ils soient phtalates ou non, et d'encourager auprès de cette population des pratiques visant à limiter leur exposition durant la grossessePhthalates are chemical compounds that have been used for decades as plasticizers in various everyday products, including food packaging, toys, and medical devices. However, these substances are also recognized as endocrine disruptors, with potentially harmful effects on human health, particularly reproduction. Their link to complications such as preterm births and fetal developmental disorders has raised significant concerns. In response, alternative plasticizers like DINCH (1,2-cyclohexanedicarboxylic acid diisononyl ester) have been developed to replace phthalates. However, the long-term impacts of these alternatives on health, particularly on fetal membranes, remain unclear.DINCH is now used in products targeting sensitive populations, such as pregnant women and infants. Although these substances are considered promising, there remains a lack of sufficient data to guarantee their safety, particularly regarding their potential impact on pregnancy. Among pregnancy-related complications, preterm premature rupture of membranes (PPROM) is a major factor in preterm births, affecting approximately 3% to 4% of pregnancies and contributing to 50% of preterm deliveries. The role that plasticizers, whether phthalates or non-phthalates, may play in this pathology is still underexplored.This thesis focuses on exploring the effects of these non-phthalate plasticizers, specifically DINCH and its metabolite MINCH (1,2-cyclohexanedicarboxylic acid mono-4-methyloctyl ester), on the physiology of human fetal membranes. More precisely, the study examines the impact of these substances on the nuclear receptor PPARγ, a key player in maintaining pregnancy and regulating inflammatory processes. PPARγ plays a central role in placental development and inflammation control, both essential for a successful pregnancy. The main objective of this work is to assess whether these alternative plasticizers disrupt this signaling pathway and, thus, compromise the integrity of fetal membranes, potentially leading to their premature rupture.Experiments were conducted using a model of human amniotic epithelial cells to explore the potential toxicity of the plasticizers, as well as their effects on PPARγ expression and activity. The results indicate that DINCH and its metabolite MINCH do not cause major disruptions to PPARγ activity contrary to phthalate.In conclusion, this study paves the way for a better understanding of the potential risks associated with non-phthalate plasticizers on reproductive health. Although the results obtained seem encouraging regarding the safety of DINCH and MINCH, it is crucial to conduct further studies to ensure their long-term safety, particularly concerning the prevention of premature rupture of fetal membranes and the resulting preterm births. This study also highlights the importance of informing pregnant women about the potential risks associated with exposure to plasticizers, whether phthalates or non-phthalates, and encouraging practices to limit their exposure during pregnancy
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Wiberg-Itzel, Eva. « Ante partum determination of lactate in amniotic fluid / ». Stockholm, 2005. http://diss.kib.ki.se/2005/91-7140-370-1/.
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Machtejevienė, Eglė. « Peptide pattern of amniotic fluid and its correlation with protein composition of fetal membranes : the search for new potential biomarkers to predict preterm premature rupture of membranes ». Doctoral thesis, Lithuanian Academic Libraries Network (LABT), 2013. http://vddb.laba.lt/obj/LT-eLABa-0001:E.02~2013~D_20130919_143805-88333.
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The aim of the research was to find new potential biomarkers of preterm premature rupture of membranes. The amniotic fluid and fetal membranes peptidic composition was analyzed using a fully automated 2D liquid chromatographic system coupled to mass spectrometry. A comparison of peptidomes of amniotic fluid and amniochorionic membranes with preterm premature rupture and term intact membranes was performed. Ten proteins from amniotic fluid were identified as potential biomarkers for PPROM. The created map of amniotic fluid peptides and proteins depending on the gestational age is important for proteomics-based identification of biomarkers for fetal abnormalities and other pregnancy complications.Mokslinio darbo metu siekta nustatyti potencialius priešlaikinio neišnešioto vaisiaus dangalų plyšimo biožymenis. Panaudojant dvidimensinę skysčių chromatografiją bei masių spektrometriją išanalizuota vaisiaus vandenų ir dangalų peptidinė sudėtis. Ištirti ir palyginti amniochorioninės membranos ir vaisiaus vandenų peptidai bei su jais siejami baltymai, kai prieš laiką plyšta neišnešioto vaisiaus dangalai arba vaisius išnešiojamas iki numatyto gimdymo termino ir dangalai išlieka sveiki. Išanalizavus skirtumus, nustatyti nauji galimi priešlaikinio neišnešioto vaisiaus dangalų plyšimo biožymenys.
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Joyce, Sarah Julia. « Demographic, clinical and environmental risk factors for prelabour rupture of membranes in Western Australia ». University of Western Australia. School of Population Health, 2009. http://theses.library.uwa.edu.au/adt-WU2009.0126.
Texte intégralRésumé :
[Truncated abstract] This thesis explores the risk factors and perinatal outcomes associated with prelabour rupture of membranes, with a particular focus on the environmental context. Prelabour rupture of membranes is defined as the rupture of fetal membranes before the onset of labour. It is a relatively common obstetric endpoint, occurring in approximately 8-10% of pregnant women at term (PROM) and in up to 40% of all preterm deliveries (pPROM). Despite the high prevalence of the condition, the biological mechanisms and risk factors, and in particular the role of environmental predictors, behind the development of PROM and pPROM remain largely unclear. A record-based prevalence design was used to analyse a population of 16,229 nulliparous, Caucasian women residing in Perth, Western Australia who gave birth to a single newborn during 2002-2004. Maternal age, socioeconomic status and threatened preterm labour during pregnancy were identified as risk factors for prelabour rupture of membranes. Term PROM was significantly associated with fetal distress (OR 1.19; 95%CI 1.00-1.43) and post-partum haemorrhage (OR 1.99; 95%CI 1.60-2.48). A number of perinatal complications were observed to be associated with the presentation of preterm PROM, including prolapsed cord (OR 13.95; 95%CI 4.57-42.61), ante-partum haemorrhage (OR 3.29; 95%CI 2.20-4.91), post-partum haemorrhage (OR 2.12; 95%CI 1.54-2.91), low birth weight (OR 17.79; 95%CI 13.87-22.82), very low birth weight (OR 20.01; 95%CI 14.12-28.35) and stillbirth (OR 5.42; 95%CI 2.87-10.21). However, the outcomes were similar between pPROM patients and other preterm deliveries, indicating that the complications arose due to the timing of the delivery. In contrast though, the risk factors between the two outcomes varied which may suggest that a different aetiological pathway exists between preterm PROM and other preterm deliveries. The frequency of complications decreased with increasing gestational age at delivery until the pregnancy reached full-term, whereupon an increase in gestational age at delivery resulted in an increased risk of fetal distress and post-partum haemorrhage. This finding is novel and may have important implications for the management of prelabour rupture of membranes, specifically with regard to the relative risks and benefits of expectant management (that is, the patient is admitted to an obstetric facility or hospital and closely monitored) versus planned delivery. ... This study represents the first attempt to investigate the potential associations between environmental risk factors and prelabour rupture of membranes. The results of the thesis provide a substantial contribution to our knowledge on prelabour rupture of membranes, including findings of direct relevance to clinical practice as well as a potentially contributing environmental exposure pathway. These original findings suggest a possible preventative approach to reducing the occurrence and associated morbidity of prelabour rupture of membranes may be feasible, and should be pursued if future research confirms the preliminary findings of this thesis.
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Kiyokawa, Hikaru. « Maternal Glucocorticoids Make the Fetal Membrane Thinner : Involvement of Amniotic Macrophages ». Kyoto University, 2020. http://hdl.handle.net/2433/253158.
Texte intégralLivres sur le sujet "Premature rupture of fetal membranes"
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D, Wenstrom Katherine, et Weiner Carl P, dir. Premature rupture of membranes. Philadelphia : Saunders, 1992.
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Seiichiro, Fujimoto, dir. Recent advance in diagnosis of preterm premature rupture of the membranes. Sapporo, Japan : Hokkaido University School of Medicine, 1998.
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Oskamp, Marilynne. The lived experience of women with preterm premature rupture of the membranes, PPROM, who remained at home until delivery of their infants. Ottawa : National Library of Canada = Bibliothèque nationale du Canada, 1999.
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Goulet, Céline *. Risk factors associated with preterm, premature rupture of fetal membranes. 1989.
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Chien, Edward. Premature Rupture of Membranes, an Issue of Obstetrics and Gynecology Clinics. Elsevier, 2020.
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Fox, Grenville, Nicholas Hoque et Timothy Watts. Antenatal care, obstetrics, and fetal medicine. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198703952.003.0001.
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This chapter contains details of methods used for screening and diagnosis of fetal anomalies using antenatal blood tests, ultrasound scanning, chorionic villous sampling, amniocentesis, and fetal blood sampling. There are sections on pre-existing maternal diseases presenting risks to the fetus including maternal diabetes, systemic lupus erythematosus, thrombocytopenia, and neuromuscular disease, as well as those specific to pregnancy—pre-eclampsia, HELLP syndrome, and eclampsia. Intrauterine growth restriction and monitoring is covered in detail. The increased fetal risks of multiple birth due to twin-to-twin transfusion syndrome and other pregnancy complications are described, with detail on oligohydramnios, polyhydramnios, antepartum haemorrhage, preterm prelabour rupture of membranes, cord prolapse, preterm labour, and breech presentation. Intrapartum fetal assessment using electronic fetal monitoring and fetal blood sampling to diagnose fetal distress is covered to enable health professionals involved in care of the newborn to understand events which may have resulted in a baby born in poor condition.
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Juri Moran, Joulia Marianita, Paulina Elizabeth Durán Mora, Estefania Vanessa Arauz Andrade, Yessenia Isabel Sarchi Guayasamin, Alejandra Elizabeth Vasquez Fuel, Cesar Wladimir Reyes Padilla, Pamela Nathaly Pastrano Coronado, Lucia Paola Rodriguez Paz, Martha Elizabeth Aguilar Villagran et Oscar Andres Toapanta Proaño. Ginecología Obstetricia : Patologías durante el embarazo. Mawil Publicaciones de Ecuador, 2019, 2020. http://dx.doi.org/10.26820/978-9942-826-07-7.
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En Medicina, el área de aplicación de Ginecología, la ciencia de la mujer condensa el estudio de las enfermedades frecuentes y graves, el diagnóstico, detección de los factores de riesgo y establecer mecanismos de prevención, prescribir los tratamientos médicos y quirúrgicos de las enfermedades del sis- tema reproductor femenino, entiéndase, todo lo relacionado con la vagina, las mamas, el útero y los ovarios. Durante el siglo XX, motivado por el crecimiento acelerado del conocimien- to científico y médico, se acrecienta la toma de conciencia del rol que le co- rresponde desempeñar a la medicina en el sector de la salud y la protección de la mujer embarazada. Los problemas del trato genital femenino cuando se asumen como responsabilidad de los ginecólogos, quienes incluyeron dentro del proceso de auscultación, diagnóstico y tratamiento aspectos fisiológicos y endocrinos. Las barreras de la formación académica se fueron difuminando y los ginecó- logos y obstetras comenzaron a estrechar su campo laboral y como resultante se constituyó la Ginecobstetricia. En el marco de estas reflexiones, surge la idea de la presentación de un tex- to titulado Ginecología – Obstetricia, mediante el cual se pretende hacer una contribución real a nivel teórico que permita apoyar a profesionales y estu- diantes en el área de salud humana, básicamente en algunas de las patologías o complicaciones médicas asociadas al embarazo, y tratadas por la especialidad obstétrica, así mismo, se abordan dos temas (1 y 2) de conocimiento general. Cabe indicar que el texto no pretende abordar la vasta información o literatura que sobre los temas se han tratado. El libro ha sido estructurado bajo el perfil de diez (10) temas que discurren estrictamente sobre contenidos específicos, a sa- ber: 1. El parto y sus fases, 2. Pruebas de Bienestar Fetal, 3. Amenaza de Parto Pretérmino, 4. Ruptura Prematura de Membranas, 5. Amenaza de aborto, 6. Desprendimiento de placenta, 7. Infecciones de vías urinarias en embarazadas, 8. Diabetes Gestacional, 9. Hipertension en las embarazadas y 10. Preeclamp- sia y eclampsia En el primer tema, el Parto y sus fases, se precisan diferentes nociones sobre 26 GINECOLOGIA - OBSTETRICIA el proceso y el resultado de parir (dar a luz). A lo largo de la historia ha evolu- cionado el conocimiento de este tema dando como resultado una terminología precisa sobre los diferentes tipos de parto: parto natural, parto normal, parto ins- trumental, parto pretérmino, parto humanizado, etc. Estas nociones obedecen a determinadas circunstancias específicas que lo circunscribe como el uso o no de instrumentos que ayuden al nacimiento de un feto. De manera general, el parto marca el final del embarazo y el nacimiento de la criatura que se engendraba en el útero de la madre. Este proceso por el que la mujer o la hembra de una especie vivípara expulsa el feto y la placenta al final de la gestación consta de tres fases: la fase de dilatación, la de expulsión y la placentaria o de alumbramiento. En el segundo tema titulado Pruebas de Bienestar Fetal, se destaca el desa- rrollo de diferentes pruebas para el control del bienestar fetal. Éstas constitu- yen las técnicas aplicadas a las madres que permiten predecir el posible riesgo fetal o hacer un pronóstico del estado actual del feto, es decir, que tratan de conseguir a través de una valoración del feto de forma sistemática, la identifi- cación de aquellos que están en peligro dentro del útero materno, para así to- mar las medidas apropiadas y prevenir un daño irreversible. Se abordan en este contexto las indicaciones y los métodos (clínicos, biofísicos y bioquímicos más utilizados para el control de bienestar fetal. En el tema tres (3) denominado Amenaza de Parto Pretérmino, el trabajo se centra, en el desarrollo de los siguientes ítems. La Definición de Parto Pretérmi- no, la Definición de amenaza de Parto Pretérmino, la Evaluación del riesgo, la etiología, la Clínica de la Amenaza de Parto Pretérmino, el Diagnóstico precoz de la Amenaza de Parto Pretérmino, la Evaluación de gestantes que acuden a emergencia por signos y síntomas de Amenaza de Parto Pretérmino y el trata- miento. El trabajo parte de la definición de Parto Pretérmino entendido como aquel que ocurre después de la semana 23 y antes de la semana 37 de gestación, para posteriormente, tratar lo relativo a la Amenaza de Parto Pretérmino (APP) definido como el proceso clínico sintomático (Aparición de dinámica uterina regular acompañado de modificaciones cervicales) que puede conducir a un parto pretérmino. Su etiología es compleja y multifactorial, en la que pueden intervenir de forma simultánea factores inflamatorios, isquémicos, inmunológi- cos, mecánicos y hormonales. 27 GINECOLOGIA - OBSTETRICIA Por otro parte, el tema cuatro (4) expone la Ruptura Prematura de Membra- nas, la cual constituye una complicación usual en la práctica obstétrica, esta puede aumentar la incidencia en la morbilidad y mortalidad materna – fetal. Múltiples estudios se están llevando a cabo para poder dilucidar completamente su fisiopatología, lo cual se hace cada vez más necesario para poder aplicar estos conceptos en la práctica clínica, la evidencia actual indica que la Ruptura Prematura de Membrana es un proceso que puede ser afectado por factores: bioquímicos, fisiológicos, patológicos y ambientales. El capítulo cinco (5) comprende la temática sobre la Amenaza de aborto. (AA) que es la complicación más común durante el embarazo, se define como el sangrado transvaginal antes de las 20 semanas de gestación (SDG) gestación o con un feto menor de 500g, con o sin contracciones uterinas, sin dilatación cervical y sin expulsión de productos de la concepción”. Es decir, se presenta hemorragia de origen intrauterino antes de la vigésima semana completa de ges- tación, con o sin contracciones uterinas, sin dilatación cervical y sin expulsión de los productos de la concepción. Los síntomas abarcan amenorrea secundaria, presencia de vitalidad fetal y cólica abdominales con o sin sangrado vaginal entre otros. Para el diagnóstico se puede hacer una ecografía abdominal o va- ginal, examen pélvico y de laboratorio. En un principio el tratamiento consiste en recomendar reposo en cama y reposo pélvico. La identificación de factores de riesgo, el Ultrasonido obstétrico y la medición de marcadores bioquímicos son de gran importancia para realizar un diagnóstico y establecer un pronóstico oportuno. Estos aspectos y otros relacionados con el tema como son: la clínica, el protocolo a seguir, el tratamiento y la prevención, son tratados en este capí- tulo. El tema Desprendimiento de placenta es desarrollado a lo largo del tema seis (6). Su contenido aborda los aspectos importes como los factores de riesgo, etiología, síntomas y signos, diagnóstico y tratamiento de esta complicación cuyo proceso se caracteriza por el desprendimiento total o parcial, antes del parto, de una placenta que esta insertada en su sitio normal. Este hecho que puede traer grandes consecuencias para el feto y para la madre, puede ocurrir en cualquier momento del embarazo. Los desprendimientos producidos antes de las 20 semanas, por su evolución, deberán ser tratados como abortos. Los que tienen lugar después de la semana 20 de gestación y antes del alumbramiento constituyen el cuadro conocido como desprendimiento prematuro de la placenta normalmente insertada. (abrptio plantae o accidente de Baudelocque). El pro- ceso ha tenido una variedad de denominaciones a lo largo del tiempo y son consecuencia de la diversidad de cuadros clínicos que pueden producirse, sien- do las más empleadas en la actualidad: abruptio placentae, ablatio placentae, desprendimiento prematuro de placenta normalmente inserta (DPPNI), junto con el término abreviado desprendimiento prematuro de placenta (DPP). Para hablar de otra importante complicación que aqueja a la gestante y su bebe por nacer se expone en el tema (7) relacionado con las Infecciones de vías urinarias en embarazadas. Los particulares cambios morfológicos y funcio- nales que se producen en el tracto urinario de la gestante hacen que la infec- ción del tracto urinario (ITU) sea la segunda patología médica más frecuente del embarazo, por detrás de la anemia. Las 3 entidades de mayor repercusión son: Bacteriuria asintomática (BA) (2-11%), cuya detección y tratamiento son fundamentales durante la gestación, pues se asocia a prematuridad, bajo peso y elevado riesgo de progresión a pielonefritis aguda (PA) y sepsis; la Cistitis aguda (CA) (1,5%) y la Pielonefritis aguda (1-2%), principal causa de ingreso no obstétrico en la gestante, que en el 10 al 20% de los casos supone alguna complicación grave que pone en riesgo la vida materna y la fetal. La Diabetes Gestacional se ubica y desarrolla en el tema ocho (8). Este tipo de diabetes que aparece o se diagnostica durante el embarazo ha aumentado su prevalencia y cobrado gran relevancia epidemiológica en los últimos años. La Diabetes Gestacional (DG) o Diabetes Mellitius Gestacional (DMG) se carac- teriza por una secreción de insulina insuficiente para compensar la resistencia a la hormona, propia del embarazo. Después del parto, los niveles de glucosa sanguínea suelen normalizarse; sin embargo, algunas mujeres desarrollan DM tipo 2 y se asocia con complicaciones graves en la madre y el hijo, incluso años después del nacimiento. La Hipertensión en las Embarazadas, tema tan tratado y controvertido en los últimos años por su significación a nivel de que es la complicación médica 29 GINECOLOGIA - OBSTETRICIA más frecuente de la gestación y ocurre según estudios comprobados en el 7% a 10% de los embarazos y constituye una causa importante de morbimortalidad materna y perinatal. De manera clásica, la HTA en el embarazo ha sido definida como el incremento, durante la gestación, de la presión arterial sistólica (PAS) en 30 mmHg o más y/o la presión arterial diastólica (PAD) en 15 mmHg o más comparado con el promedio de valores previos a la 20va. semana de gestación. Cuando no se conocen valores previos, una lectura de 140/90 mmHg o mayor es considerada como anormal. El tema desarrollado abarca una visión general sobre algunos aspectos relativos a la definición y su clasificación, los factores predisponentes, sintomatología, diagnóstico, tratamiento, etc. Por último, el tema 10 aborda dos alteraciones íntimamente ligadas a la hi- pertensión arterial en el embarazo: la preeclampsia y la eclampsia. Éstas son en ocasiones tratadas como componentes de un mismo síndrome ya que la pree- clampsia es la hipertensión de reciente comienzo con proteinuria después de las 20 semanas de gestación y la eclampsia es la presencia de convulsiones genera- lizadas inexplicables en pacientes con preeclampsia.
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Belcher, Harolyn M. E., et Samantha Hutchison. Neurobiology of Intrauterine Opiate and Cocaine Exposure. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199937837.003.0182.
Texte intégralRésumé :
Drug abuse results from a complex interplay among the drug, the individual and the socio-cultural environment. Current pain reliever, heroin, and OxyContin® use is reported in 0.9% (n = 19,000), 0.2% (n = 4,000), and 0.1% (n = 3,000), respectively, of pregnant women in the United States each year. Cocaine use was reported in 0.2% of pregnant women. Intrauterine drug exposure to opiates is associated with risk for narcotic abstinence syndrome, prenatal infections, and sudden infant death. Illicit drug use during pregnancy also places the mother-to-be at risk for reduced prenatal care, obstetric complications, including abruption placentae, prolonged rupture of membranes, and fetal distress. This chapter focuses on the neurobiological effects of intrauterine opiate and cocaine exposure on the developing fetus.
Chapitres de livres sur le sujet "Premature rupture of fetal membranes"
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Masson, M. « Fibrin Sealing by Tissucol in Premature Rupture of the Fetal Membranes ». Dans Gynecology and Obstetrics Urology, 41–48. Berlin, Heidelberg : Springer Berlin Heidelberg, 1994. http://dx.doi.org/10.1007/978-3-642-48717-0_9.
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Shimoya, Koichiro. « Premature Rupture of Membranes ». Dans Preterm Labor and Delivery, 207–12. Singapore : Springer Singapore, 2019. http://dx.doi.org/10.1007/978-981-13-9875-9_21.
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Lyons, Paul, et Nathan McLaughlin. « Premature Rupture of Membranes ». Dans Obstetrics in Family Medicine, 73–78. Cham : Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-39888-0_9.
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Lyons, Paul. « Premature Rupture of Membranes ». Dans Obstetrics in Family Medicine, 65–70. Cham : Springer International Publishing, 2015. http://dx.doi.org/10.1007/978-3-319-20077-4_8.
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Arnold, Kate C., et Caroline J. Flint. « Premature Rupture of Membranes ». Dans Obstetrics Essentials, 291–97. Cham : Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-57675-6_43.
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Esteves, Juliana Silva. « Premature Rupture of Membranes ». Dans Perinatology, 635–46. Cham : Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-83434-0_36.
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Fisher, Zoë R., et Adeola A. Kosoko. « Premature Rupture of Membranes ». Dans Emergency Medicine Case-Based Guide, 99–107. Cham : Springer Nature Switzerland, 2024. https://doi.org/10.1007/978-3-031-70118-4_10.
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Mercer, Brian M. « Preterm Premature Rupture of Membranes ». Dans Queenan's Management of High-Risk Pregnancy, 364–73. Oxford, UK : Wiley-Blackwell, 2012. http://dx.doi.org/10.1002/9781119963783.ch43.
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Ghuman, Navdeep Kaur, et Pratibha Singh. « Preterm Premature Rupture of Membranes ». Dans Labour and Delivery, 405–18. Singapore : Springer Nature Singapore, 2023. http://dx.doi.org/10.1007/978-981-19-6145-8_29.
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Mercer, Brian. « Premature Rupture of the Membranes ». Dans Protocols for High-Risk Pregnancies, 448–60. Oxford, UK : Wiley-Blackwell, 2010. http://dx.doi.org/10.1002/9781444323870.ch54.
Texte intégralActes de conférences sur le sujet "Premature rupture of fetal membranes"
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Bolotă, Maria, Mihaela Gavrilă, Roxana-Emanuela Ambrozie, Raluca-Maria Munteanu, Sorana-Caterina Anton et Emil Anton. « Oxidative Stress Assesmennt in Preterm Premature Rupture Of Membranes (Pprom) — A New Challenge ». Dans 2024 E-Health and Bioengineering Conference (EHB), 1–5. IEEE, 2024. https://doi.org/10.1109/ehb64556.2024.10805614.
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Joyce, Erinn M., Michael S. Sacks et John J. Moore. « Structure Mechanical Function Relationships of the Fetal Membrane ». Dans ASME 2007 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2007. http://dx.doi.org/10.1115/sbc2007-176687.
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A normal pregnancy requires physical integrity of the fetal membrane (FM) until term delivery. Timely rupture of the fetal membrane is a vital part of term labor [1]. Premature failure of the FM, prior to full gestation, accounts for one third of all premature human births and affects 3% of all pregnancies [2]. Membrane rupture is either due to the release of the amniotic fluid, frequently signaling the onset of labor, or under a pathological circumstance [3]. In order to develop a rational basis for treatment and prevention of premature FM failure, we need first to understand FM structural and mechanical behavior. This includes its constituent layers at near full term under normal physiological loading states. Once these properties are established, we can then better formulate how the tissue transitions to the ability to fail at full term.
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Wahyuni, Sri, Tutik Rahayu et Apriliani Yulianti Wuriningsih. « Spiritual Endorphine Stimulation as Methods to Increase Fetal Well Being on Pregnant Woman with Early Premature Rupture of Membranes ». Dans The 9th International Nursing Conference : Nurses at The Forefront Transforming Care, Science and Research. SCITEPRESS - Science and Technology Publications, 2018. http://dx.doi.org/10.5220/0008331306990702.
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Balestra, Amanda Fernandes de Sousa Oliveira, Flávia Pascoal Teles et Karine Felipe Martins. « Fetal surgery in the context of myelomeningocele : repercussions and prognosis ». Dans XIII Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/1516-3180.055.
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Background: Myelomeningocele (MMC) is a congenital malformation of neural tube closure. The clinical picture comprises sensory and motor deficits at the point of spinal cord injury and below, in addition to ventriculomegaly, which requires ventriculo-peritoneal drains (DVP). Exposure of nervous tissue to amniotic fluid and trauma to the uterine wall, generates secondary damage. Intrauterine correction is the gold standard for MMC and aims to reduce organic and functional sequelae, improving the patient’s neurological prognosis. Objectives: The objective of this work is to identify the impact of fetal surgery against MMC. Methods: An integrative literature review was carried out based on articles selected from the Google Scholar and Scientific Eletronic Library Online databases. Results: The benefits of intrauterine neurosurgery outweigh the harm, based on maternal complications. Such maternal risks are: oligohydramnios, spontaneous rupture of the membrane, uterine dehiscence, premature birth, infections, blood transfusion, acute lung edema and contraindication for vaginal delivery due to uterine scarring. For the child, all the studies analyzed showed the same gains, extremely significant when compared to postnatal surgery: better cognitive development, greater probability of walking without using orthoses, less need for DVP. The gains from the fetal surgery technique go beyond the postnatal intervention. Conclusions: Therefore, the importance of early intrauterine treatment, in a properly equipped place and by qualified professionals, is reiterated, offering comprehensive care to pregnant women, preventing potential impasses and aiming at a better prognosis and quality of life for the child.
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Набеева, Диана Альбертовна, Екатерина Пантелеевна Корняева, Татьяна Владимировна Микрюкова, Алена Александровна Караваева, Сергей Анатольевич Серебряков, Сахила Низамовна Мулкадарова et Мария Александровна Осетрова. « ANALYSIS OF RISK FACTORS OF PRETERM PREMATURE RUPTURE OF MEMBRANES ». Dans Высокие технологии и инновации в науке : сборник избранных статей Международной научной конференции (Санкт-Петербург, Май 2020). Crossref, 2020. http://dx.doi.org/10.37539/vt185.2020.12.69.037.
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Статья посвящена анализу и выявлению факторов риска преждевременного излития околоплодных вод (ПИОВ). Проводится ретроспективный сравнительный анализ исхода родов для плода и матери с и без ПИОВ. The article is devoted to the analysis and identification of risk factors for preterm premature rupture of membranes (PPRM). A retrospective comparative analysis of the outcome of labor for the fetus and mother with and without PPRM is carried out.
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Ameye, L., J. De Brabanter, J. A. K. Suykens, I. Cadron, R. Devlieger, D. Timmerman, B. Spitz et S. Van Huffel. « Predictive Models for Long Term Survival after Premature Rupture of Membranes ». Dans 2005 IEEE Engineering in Medicine and Biology 27th Annual Conference. IEEE, 2005. http://dx.doi.org/10.1109/iembs.2005.1615500.
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Salmarini, Desilestia. « The Analysis Factors Premature Rupture Of Membranes At Ansari Saleh General Hospital Banjarmasin ». Dans Proceedings of the First National Seminar Universitas Sari Mulia, NS-UNISM 2019, 23rd November 2019, Banjarmasin, South Kalimantan, Indonesia. EAI, 2020. http://dx.doi.org/10.4108/eai.23-11-2019.2298401.
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Pratiwi, Ika, Melyana Nurul Widyawati et Suryono Suryono. « Pattern Recognition Image Color for Premature Rupture of Membranes Diagnosis Using Euclidean Algorithm ». Dans 2019 Fourth International Conference on Informatics and Computing (ICIC). IEEE, 2019. http://dx.doi.org/10.1109/icic47613.2019.8985701.
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Brun, R., J. Girsberger, M. Rothenbühler, C. Argyle, J. Hutmacher, C. Haslinger et B. Leeners. « Wearable sensors for prediction of intraamniotic infection in women with Preterm Premature Rupture of Membranes ». Dans 30. Kongress der Deutschen Gesellschaft für Perinatale Medizin – „Wandel als Herausforderung“. Georg Thieme Verlag, 2021. http://dx.doi.org/10.1055/s-0041-1739756.
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Oyen, Michelle L., Virginia L. Ferguson et Steven E. Calvin. « Fracture Resistance of Human Amnion ». Dans ASME 2007 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2007. http://dx.doi.org/10.1115/sbc2007-174552.
Texte intégralRésumé :
While normal delivery requires disruption of the placental membranes (the “breaking of waters”), in one third of premature births delivery results from with mechanical rupture of the placental membranes prior to full-term gestation [1]. The biomechanical investigation of membrane rupture has thus been a subject of recent study [2–5]. In particular, mechanical investigations aimed specifically at understanding the membrane rupture process have concluded that the chorioamnion membrane bilayer breaks in two separate events, such that the chorion and amnion component layers fail independently, and that the delamination of the chorioamnion may represent a significant fraction of the total mechanical work done in membrane rupture [5]. The amnion is the stiffer and stronger of the two membrane layers, consisting primarily of a dense type I collagen network.