Bibliographic Details
| Title: |
Tratamiento de la ruptura prematura de membranas pretérmino (24-33.6 semanas): evidencia científica reciente. |
| Alternate Title: |
Management of premature preterm rupture of membranes (24-33.6 weeks): Recent scientific evidence. |
| Authors: |
Rodríguez-Bosch, Mario Roberto1, Miranda-Araujo, Osvaldo2 osvimi@yahoo.com, Reséndiz-Rossetti, Ana Eugenia3 |
| Source: |
Ginecología y Obstetricia de México. May2018, Vol. 86 Issue 5, p319-334. 16p. |
| Subjects: |
PREMATURE rupture of fetal membranes, PREMATURE labor, PREGNANCY complications, PUBMED (Online service), FETAL membrane abnormalities |
| Abstract (English): |
OBJECTIVE: To provide the clinician the most recent scientific evidence regarding some aspects of the management of patients with preterm premature rupture ofmembranes. Those aspects have generated debate, controversy and sometimes divergent opinions leading to medical decisions based on weak criteria and as consequence significant perinatal morbidity. METOD: We searched databases in PubMed, The Cochrane Library, OVID, Science Direct, Practice Guidelines International Networks from 2014 to 2016 with the following keywords: preterm premature rupture of membranes, diagnostic tests for preterm premature rupture of membranes, antenatal corticosteroids, antibiotic therapy in preterm premature rupture of membranes, fetal pulmonary maturity tests, fetal inflammatory response syndrome, fetal well-being tests, chorioamnionitis. RESULTS: We extracted 70 studies, information was collected with emphasis on several controversial themes. Inclusion criteria were systematic reviews, meta-analysis and clinical controlled trials from 2014 to 2016, languages spanish or english, articles with evidence-based medicine methodology with strong recommendations. The final selection includes 5 international clinical practice guidelines and. 45 articles from 2014-2016. Articles which methodology consisted in case-control design, uncontrolled or unrandomized clinical trials or with level of evidence D were excluded. CONCLUSIONS: The appropriate use of diagnostic tools will allow us to become more efficient in the use of resources, also allowing the identification of fetuses that would benefit from an expectant versus resolute management and vice versa. The review aims, among other things, to reduce the incidence of adverse neonatal outcomes associated with infectious processes, which are directly related to morbidity and neurological sequelae in short and mid-term. The management of PPROM is proposed in algorithms applicable in clinical practice. [ABSTRACT FROM AUTHOR] |
| Abstract (Spanish): |
OBJETIVO: Ofrecer al clínico la evidencia científica más reciente en lo relativo a algunos aspectos de la atención de pacientes con ruptura prematura pretérmino de membranas que han generado debate, controversia y, en algunos momentos, opiniones divergentes que condicionan la toma de decisiones basadas en criterios con un débil rigor científico que se reflejan en morbilidad perinatal significativa. MÉTODO: Búsqueda en PubMed, The Cochrane Library, OVID, Science Direct, Practice Guidelines Internacional Networks de artículos publicados en inglés entre los años 2014 a 2016 con las siguientes palabras clave (Mesh): Preterm premature rupture of membranes; diagnostic tests in premature rupture of preterm membranes; pulmonary maturity scheme; antibiotic therapy in premature rupture of preterm membranes; pulmonary maturity tests; fetal inflammatory response syndrome; fetal well-being tests; chorioamnionitis. Criterios de inclusión: revisiones sistemáticas, metanálisis y ensayos clínicos controlados con metodología de medicina basada en evidencias, con consistencia y claridad en las recomendaciones seleccionadas. RESULTADOS: Se seleccionaron 70 artículos, entre estos 5 guías internacionales de práctica clínica y 45 artículos. Al final se excluyeron 20 artículos porque el diseño era de casos y controles, ensayos clínicos no controlados y sus recomendaciones no eran concluyentes porque su nivel de evidencia era bajo. CONCLUSIONES: El uso racional de los diversos instrumentos de diagnóstico permite ser más eficaces y eficientes en la utilización de los recursos, y la identificación de fetos que podrían beneficiarse de una conducta expectante versus resolutiva y, viceversa. La comprensión y aplicación de lo aquí expuesto puede contribuir a disminuir la incidencia de desenlaces neonatales adversos asociados con procesos infecciosos directamente relacionados con la morbilidad y secuelas neurológicas a corto y mediano plazo. Se planteó el tratamiento de la ruptura prematura pretérmino de membranas en algoritmos aplicables en la práctica clínica. [ABSTRACT FROM AUTHOR] |
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| Database: |
MedicLatina |
