Rodríguez-Bosch MR, Miranda-Araujo O, Reséndiz-Rossetti AE

Language: Spanish
References: 0
Page: 319-334
PDF size: 519.39 Kb.

ABSTRACT

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.
Method: 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.