Rupture of membranes, premature Archives - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(9):509-515
DOI 10.1590/S0100-72031998000900004
Purpose: to evaluate the efficacy of four antibiotic regimens in puerperal infection prophylaxis. Patients and Methods: According to vaginal or abdominal delivery and risk the presence or not of factors for puerperal infection, the patients were allocated to groups of low, medium and high risk for its development. Between March 1994 and June 1997 2,263 patients were evaluated. Results: the incidence of puerperal infection was different in each group. It was 3.1% in the low risk group, where no antibiotic was given, and 8.5% in the high risk group where all patients received three doses of 1 g EV cefalotin at six-hour intervals. In the medium risk group, the incidence of puerperal infection was 5.3% for the patients who used three doses of 1 g EV cefoxitin; 5.1% for those who used three doses of 1 g EV cefalotin; 4.0% when a single cefoxitin dose was used and 3.4% when a single cefalotin dose was used. Conclusions: it is not necessary to use prophylactic antibiotic therapy in low risk patients and the first generation cephalosporins (cefalotin) are as efficacious as the second generation cephalosporins (cefoxitin) to prevent puerperal infection, independent of the applied dosage. Cefalotin seems to be effective in preventing puerperal infection in patients at high risk.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(9):509-515
DOI 10.1590/S0100-72031998000900004
Purpose: to evaluate the efficacy of four antibiotic regimens in puerperal infection prophylaxis. Patients and Methods: According to vaginal or abdominal delivery and risk the presence or not of factors for puerperal infection, the patients were allocated to groups of low, medium and high risk for its development. Between March 1994 and June 1997 2,263 patients were evaluated. Results: the incidence of puerperal infection was different in each group. It was 3.1% in the low risk group, where no antibiotic was given, and 8.5% in the high risk group where all patients received three doses of 1 g EV cefalotin at six-hour intervals. In the medium risk group, the incidence of puerperal infection was 5.3% for the patients who used three doses of 1 g EV cefoxitin; 5.1% for those who used three doses of 1 g EV cefalotin; 4.0% when a single cefoxitin dose was used and 3.4% when a single cefalotin dose was used. Conclusions: it is not necessary to use prophylactic antibiotic therapy in low risk patients and the first generation cephalosporins (cefalotin) are as efficacious as the second generation cephalosporins (cefoxitin) to prevent puerperal infection, independent of the applied dosage. Cefalotin seems to be effective in preventing puerperal infection in patients at high risk.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(9):495-501
DOI 10.1590/S0100-72031998000900002
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 were randomly divided into two groups: active management, with oxytocin induction of labor until 6 h of PROM; and expectant management, waiting for the spontaneous onset of labor up to 24 h. The data were analyzed with the Epi-Info and SPSS-PC+ packages, using the statistical c², Student's t and log-rank tests. Results: the results indicate that the differences between the two managements concern to the longer time needed for the expectant management group until onset of labor and delivery, besides the higher number of women and neonates who remained in hospital for more than three days. Conclusions: the time between admission and onset of labor and delivery, and also the latent period were longer in the expectant management group.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(9):495-501
DOI 10.1590/S0100-72031998000900002
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 were randomly divided into two groups: active management, with oxytocin induction of labor until 6 h of PROM; and expectant management, waiting for the spontaneous onset of labor up to 24 h. The data were analyzed with the Epi-Info and SPSS-PC+ packages, using the statistical c², Student's t and log-rank tests. Results: the results indicate that the differences between the two managements concern to the longer time needed for the expectant management group until onset of labor and delivery, besides the higher number of women and neonates who remained in hospital for more than three days. Conclusions: the time between admission and onset of labor and delivery, and also the latent period were longer in the expectant management group.
