[Antibiotic treatment in threatened preterm labor].
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Anti-Bacterial Agents↗
Biomedical subjects
J A Svare
Publications and source records attributed to J A Svare.
[Relation between cervical conization, microbial colonization and threatening preterm labor].
UNLABELLED: The relationship between prior cervical conization, the cervical microbial colonization and threatening preterm delivery was investigated in 35 women with preterm premature rupture of the membranes (PPROM), 38 women with idiopathic preterm labor and 75 normal pregnant women at 26-34 weeks of gestation. Prior cervical conization occurred with a significantly higher frequency in PPROM patients than in patients with preterm labor (p < 0.01) and normal pregnant women (p < 0.001). The prevalence of lactobacilli was lower in patients with PPROM than in patients with preterm labor (p < 0.05) and control patients (p = 0.05)--and lower in patients with prior cervical conization than in patients without prior conization (p < 0.05). All other microorganisms occurred with the same frequencies in all groups. CONCLUSIONS: Prior conization was associated with PPROM. Women with prior conization and women with PPROM had a reduced prevalence of lactobacilli in the cervix. The "absence" of lactobacilli may indicate changes in the cervical microflora, which could be of importance for PPROM.
Adult↗
[Heterotopic pregnancy after in vitro fertilization].
Until December 1991, 1171 pregnancies had been established in Denmark after in vitro fertilization and embryo transfer (IVF-ET). Thirteen of these pregnancies were heterotopic (1.1%). Three patients were asymptomatic, four patients presented with an acute abdomen, five had abdominal pain and only two patients had vaginal bleeding. In five cases the diagnosis of heterotopic pregnancy was made by ultrasound, while eight cases were diagnosed at the time of surgery. Eleven patients were treated in the first trimester, while two patients were treated at 23 and 38 weeks of gestation, respectively. In nine of the thirteen cases the intrauterine pregnancy resulted in term delivery. Heterotopic pregnancy occurred in 1% of pregnancies following IVF-ET. Abdominal pain was the predominant symptom, while vaginal bleeding was absent in the majority of women. In most cases removal of the ectopic gestation allowed the intrauterine pregnancy to proceed until term.
Adult↗
The relationship between prior cervical conization, cervical microbial colonization and preterm premature rupture of the membranes.
The occurrence of prior cervical conization and the cervical microbial colonization was investigated in 38 women with idiopathic preterm labor, 35 women with preterm premature rupture of the membranes (PPROM) and 75 normal pregnant women at 26-34 weeks of gestation. Data were analyzed by Fisher's exact test (two-tailed). The frequency of prior cervical conization was significantly higher in PPROM patients compared to normal pregnant women (P < 0.001) and to patients in preterm labor (P < 0.01). Lactobacilli occurred with a lower frequency in patients with PPROM compared to patients in preterm labor (P < 0.05) and control patients (P = 0.0543)-and with a lower frequency in patients with prior cervical conization (P < 0.05). All other microorganisms occurred with the same frequencies in all groups. The absence of lactobacilli may indicate changes in the cervical flora, which could increase the risk of PPROM. Prior cervical conization may impair the antimicrobial defense-mechanisms in the cervix, which could facilitate ascending microbial colonization. This may lead to a release of prostaglandins and proteolytic enzymes and subsequently preterm labor and rupture of the membranes.
Adult↗
[Idiopathic preterm delivery and subclinical genital infection].
Investigations from abroad suggest that idiopathic preterm delivery may be due to ascent of microorganisms from the cervix. These may then colonize the decidua, foetal membranes and amniotic fluid and may thus precipitate preterm contractions or rupture of the membranes. In subclinical urogenital infections, antibiotic treatment appears, in some cases, to be capable of reducing the risk of preterm birth. In cases of treated premature delivery, antibiotic treatment may possibly prolong the pregnancy and prevent neonatal and puerperal infections. Further investigations are, however, recommended before introduction of routine antibiotic treatment in cases of threatened premature birth.
Amniotic Fluid↗