title: The management of cervical incompetence with protruded membranes into the vagina by vaginal irrigation with granulocyte elastase inhibitor: ulinastatin and PVP-iodine solution.
abstract: In an attempt to prevent preterm premature rupture of the membranes (PPROM) and to prolong the duration of pregnancy in patients with a dilated cervix and with the membranes protruding into the vagina, the combination therapy of irrigation with a solution containing granulocyte elastase inhibitor (ulinastatin) and PVP-iodine onto the membranes, as well as the use of antibiotics and tocolytic agents, was tested. Ten patients with protruding membranes were treated by this combination therapy and five patients were instructed to have strict bedrest without any medication. In the non-treated group, all patients were delivered within 2 days of admission and all babies had a poor prognosis. In the treated group, the pregnancy was prolonged by between 3 and 108 days (mean values 33.6 days). Only two out of 10 patients had PPROM. In cases with protruding membranes, this combination therapy seemed to be useful in preventing rupture and so prolonging the pregnancy and increasing the survival rate of the infants.
authors.affiliation: Department of Obstetrics and Gynecology, Saitama Medical Center, Saitama Medical School, Kawagoe, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Takeda
authors.forename: K
authors.initials: K
authors.lastname: Kuromaki
authors.forename: H
authors.initials: H
authors.lastname: Seki
authors.forename: K
authors.initials: K
authors.lastname: Kinoshita