Antibiotic therapy for preterm premature rupture of membranes.
Antibiotic treatment of the patient with preterm premature rupture of membranes remote from term significantly prolongs pregnancy and reduces amnionitis without increasing the risk of cesarean delivery. Antibiotic treatment reduces perinatal infectious morbidity including neonatal sepsis, GBS sepsis, and pneumonia. Stratified analysis of the currently available prospective trials also demonstrates a significant reduction in gestational-dependent morbidity, specifically respiratory distress and intraventricular hemorrhage with treatment. This is supported by a reduction in composite infant morbidity and other gestational age-dependent morbidities in the NICHD-MFMU trial. Although the optimal treatment regimen has not been determined, limited duration broad spectrum antibiotic treatment is justified in the setting of conservative management of pPROM remote from term. The patient with pPROM and documented pulmonary maturity near term may benefit more from expeditious delivery than from expectant management with antibiotics.
Mercer
B M
BM
Department of Obstetrics and Gynecology, University of Tennessee, Memphis 38103, USA. Bmercer@utmem1.utmem.edu
D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D019317:Evidence-Based Medicine; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000188:drug therapy*; D005865:Gestational Age; D006801:Humans; D008428:Maternal Mortality; D015337:Multicenter Studies as Topic; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy; D016032:Randomized Controlled Trials as Topic
D000900:Anti-Bacterial Agents