povidone-iodine and Fetal-Membranes--Premature-Rupture

Topics: Adult; Bacterial Infections; Emulsions; Female; Fetal Membranes, Premature Rupture; Humans; Infant, Newborn; Povidone-Iodine; Pregnancy; Puerperal Infection; Vagina

We examined the effects of daily vaginal disinfection on the interval between premature rupture of the membranes (PROM) and delivery and on infant outcome.. Daily vaginal disinfection with povidone iodine was performed on 43 women with PROM. The control group consisted of 59 women with PROM who did not undergo vaginal disinfection. In both groups, the infants born to these women were followed until 1 year of corrected age.. The degree of cervical dilatation, the leukocyte count, and the serum C-reactive protein level on admission did not differ between the 2 groups. Although there was no difference in the gestational week at delivery between the groups, the interval between PROM and delivery was significantly longer in the disinfectant group than among the control subjects (9.5 +/- 14.9 days vs. 3.9 +/- 5.1 days, p < 0.01). There was no difference in infant outcome between the 2 groups.. These findings suggest that daily vaginal disinfection with povidone iodine prolongs the duration of gestation in women with PROM and dose not have an adverse effect on the fetus.

Topics: Adolescent; Adult; Anti-Infective Agents, Local; Apgar Score; Birth Weight; C-Reactive Protein; Disinfection; Female; Fetal Membranes, Premature Rupture; Gestational Age; Humans; Infant; Infant, Newborn; Leukocyte Count; Povidone-Iodine; Pregnancy; Pregnancy Outcome; Ritodrine; Tocolytic Agents; Vagina

Considering the causal association of silent intrauterine infection and prematurity we investigated the possible effect of adjuvant antibiotic treatment of women with preterm labour on the appearance of inflammatory placental lesions. 140 patients with preterm labour in the 30 + 2 week of gestation (median; range: 17 + 2-34 + 6) without premature rupture of the membranes and detection of facultative-pathogenic micro-organisms in the vagina and/or in the canal of the cervix were enrolled in the study. 74 women were treated vaginally (polyvidone-iodine) in addition to intravenous tocolysis, 66 women were given ampicillin, cefotiam or erythromycin intravenously. After delivery the placentas were examined histologically and the frequency of inflammatory lesions was evaluated by use of 4 scores of classification. For statistical analysis the Fisher Exact- and the Wilcoxon Rank Sum Test were used. We found no differences concerning amnamnestic and perinatal parameters comparing the 2 groups of patients. With only one of the histological scores used (according to Salafia et al. [18]) we found a higher frequency of inflammatory placental lesion in the antibiotic treated group (12/66) in comparison to the vaginal treated group (4/74). Fifty patients of the antibiotics' group received the antibiotic during the last 10 days before birth. No differences in the frequency of inflammatory placental lesions were detectable in these patients when compared with the local treated group. However, we found a lower prolongation of gestation (calculated from the day of admission to the day of delivery, median: 7; range: 1-92 days) and a lower gestational age at delivery (median: 33 + 0; range: 22 + 2-39 + 6 weeks) in the patients receiving antibiotics during the last 10 days before birth in comparison to the local treated women (22; 1-138 days and 35 + 0; 23 + 4-41 + 5 weeks, respectively). There is the same incidence of inflammatory placental lesions in patients with preterm labour and facultative-pathogenic micro-organisms in the vagina and/or in the canal of the cervix who received adjuvant antibiotic treatment during pregnancy compared with patients who were treated vaginally with polyvidone-iodine.

Topics: Administration, Intravaginal; Ampicillin; Antibiotic Prophylaxis; Cefotiam; Chorioamnionitis; Dose-Response Relationship, Drug; Drug Administration Schedule; Erythromycin; Female; Fenoterol; Fetal Membranes, Premature Rupture; Humans; Infant, Newborn; Inflammation; Infusions, Intravenous; Obstetric Labor, Premature; Placenta; Placenta Diseases; Povidone-Iodine; Pregnancy; Tocolysis; Tocolytic Agents

Premature rupture of the membranes was diagnosed with ultrasound and subsequent injection of dye into the upper sac of a 15-week twin gestation. Because of a history of prolonged infertility, conservative treatment (including bed rest, antibiotics and intravaginal povidone-iodine pessaries) was given. Four weeks later the leakage of amniotic fluid stopped, and at 32 gestational weeks the patient delivered healthy twins by cesarean section. No sign of chorioamnionitis was noted clinically or histologically. It seems that in this unusual case the lower sac was acting as a tampon and at some stage prevented further escape of amniotic fluid as well as ascending infection.

Topics: Adult; Cephalothin; Female; Fetal Membranes, Premature Rupture; Humans; Povidone-Iodine; Pregnancy; Pregnancy, Multiple; Twins

Topics: Catheterization; Cervix Uteri; Female; Fetal Diseases; Fetal Membranes, Premature Rupture; Humans; Infection Control; Infections; Povidone; Povidone-Iodine; Pregnancy

Topics: Anti-Bacterial Agents; Antibodies, Bacterial; Bacterial Infections; Diagnosis, Differential; Female; Fetal Membranes, Premature Rupture; Gestational Age; Humans; Immunity, Cellular; Infant, Newborn; Povidone-Iodine; Pregnancy; Prognosis; Sepsis

Topics: Female; Fetal Membranes, Premature Rupture; Gestational Age; Humans; Infant, Newborn; Infant, Premature, Diseases; Infection Control; Infections; Obstetric Labor, Premature; Povidone-Iodine; Pregnancy; Pregnancy Complications, Infectious; Thyrotropin

Topics: Catheterization; Female; Fetal Membranes, Premature Rupture; Humans; Infant, Newborn; Infant, Premature, Diseases; Povidone; Povidone-Iodine; Pregnancy; Puerperal Infection; Vaginitis