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Re: Premature AmniorrexisFrom: Sass21@aol.comSat Mar 23 13:20:03 1996
> liquid with 29 weeks. No fever, cervix to 1 cm, no uterine >dinamic at all. >What my friends sugest? First Gesta. >Sorry for my english. I would interpret this as meaning PPROM (premature preterm rupture of membranes) at 29 weeks. BTW Premature = before labor Preterm = before 36 weeks (just to clear up any confusion, my residents are sometimes unclear on this) Our protocol would include *NO DIGITAL VAG EXAMS *Cervical cultures, for gonorrhea, chlamydia and GBS at least *Strongly consider antibiotics since latency (time from rupture to delivery) can be increased--see ref # 1 *Bedrest with minimal activity *Ultrasound to document fetal position, check for anomalies 1. Lewis, DF et al, Latency Period after Preterm Premature Rupture of the Membranes: a Prospective, Randomized, Double-Blind Study Comparing Ampicillin and Ampicillin-Sulbactam. Obstetrics and Gynecology. 1995;86:392-395. A small study, but demonstrated that Unasyn may be superior to ampicillin alone, and it clearly led to increased latency times in this group. Do other members of this group believe in using antibiotics for PPROM? If so, which drugs? ************************ Casey Younkin, MD, FACOG Sangamon OB/GYN So. Illinois U Med School Springfield, IL sass21@aol.com "At your cervix"
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