Premature delivery following premature rupture of membranes: increasing frequency with disappointing outcome.
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Biomedical subjects
Publications and source records attributed to John D Yeast.
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Premature labor and subsequent premature delivery is the major cause of perinatal death in the world. Numerous risk factors identify patients at jeopardy for preterm labor, but with poor sensitivity. Several biologic and biochemical markers have been recently studied that may allow early identification of patients at risk of preterm delivery. Although two markers have received Food and Drug Administration approval, a number of other tests also may ultimately prove useful.
OBJECTIVES: To quantify the extent of missing prenatal records at the time of patient presentation to a birth center, to document the age of the information in those records, and to discover how quickly missing records were retrieved. METHOD: A survey form was completed over a three-month period for each patient presenting for care. RESULTS: Prenatal records were unavailable 37% of the time at initial presentation. Records were never obtained for 20% of patients. The median age of the prenatal record was 30 days for those records that were immediately available, and the median age was 5 days for those records that were retrieved later. It took a median of 1.4 hours to retrieve a missing re-cord. CONCLUSION: Prenatal records are frequently missing at the point-of-care, and even when records are avail-able or retrieved, the information contained within them is likely to be outdated. Further research is needed to quantify both the clinical and economic impact of this problem.
The antenatal management of alloimmune thrombocytopenia (ATP) frequently requires fetal blood sampling and prophylactic platelet transfusion. A recent case of ATP complicated by associated red blood cell alloimmunization demonstrated severe hemolysis apparently as a result of ABO incompatibility from transfused platelets.
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