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Aim: To evaluate the efficacy and safety of oral misoprostol for labor induction in women with term premature rupture of membranes (PROM) and an unfavorable cervix. Methods: We randomized 130 women with PROM of ≤4 h to either oral misoprostol, 50 μg, or a placebo given every 4 h for up to three doses. Intravenous oxytocin was initiated if active labor did not begin within 12 h. Results: Sixty-four women received oral misoprostol and 66 received placebo. The PROM-to-delivery interval was shorter with misoprostol than with placebo (13.7±5.8 vs. 20.3±6.8 h, respectively, P<0.05). Misoprostol significantly reduced the need for oxytocin (28.1 vs. 72.7%, P<0.001) and antibiotics (25 vs. 69.7%, P<0.001). No significant differences in cesarean section or hyperstimulation rate were noted. Conclusion: Oral misoprostol given to women with unfavorable cervix soon after term PROM significantly reduces the induction-to-delivery time and the need for oxytocin and antibiotics. [ABSTRACT FROM AUTHOR]

The likelihood of finding chromosomal anomalies and Mendelian diseases is increased in multiple gestations compared to singletons. Prenatal diagnosis may therefore be indicated in multiple pregnancies at least as often as in singleton gestations. Invasive testing using amniocentesis or chorionic villus sampling has similar margins of safety. Chorionic villus sampling has a significant advantage over amniocentesis, because it offers rapid karyotyping and biochemical or DNA studies at an earlier stage of pregnancy. However, only experienced centers should perform these procedures, because of the technical aspects of the procedures as well as the expertise needed in the interpretation and handling of discordant results. [ABSTRACT FROM AUTHOR]

Focuses on perinatal infections cytomegalovirus and toxoplasmosis. Percentage of all congenital anomalies attributed to perinatal infections; Most common infections, including toxoplasmosis, rubella, cytomegalovirus, herpes, syphilis, varicella-zoster and parvovirus; Importance of the recognition of maternal disease and fetal monitoring; Discussion of cytomegalovirus and toxoplasmosis; Virology and epidemiology; Diagnosis.

Objective. To investigate the clinical significance of combined obstetrical pathology of small for gestational age and hydramnios as a predictor of peripartum complications, intrapartum morbidity and poor neonatal outcome. Methods. The study population consisted of 152 small for gestational age neonates with hydramnios out of 67,806 singleton deliveries during the study period (0.22%). We compared the 152 small for gestational age neonates with hydramnios (hydramnios/small for gestational age) to a sample of 1% of the appropriate for gestational age neonates with normal amniotic fluid (normal amniotic fluid/appropriate for gestational age) (582 cases). Analyses were conducted for the entire cohort as well as for the cohort in which all cases with congenital malformations were excluded. Results. There was a significantly higher rate of congenital anomalies in the hydramnios/small for gestational age group compared with the normal amniotic fluid/appropriate for gestational age group (25% vs. 2.4%, p<0.001). There were significantly more previous perinatal deaths, infertility treatments and diabetes type B-R among the hydramnios/small for gestational age group. These findings remained significant after exclusion of the neonates with congenital malformations. The rates of labor dystocia, placental abruptio, abnormal presentations, prolapse of cord and cesarean sections were significantly higher in the hydramnios/small for gestational age group compared with normal amniotic fluid/appropriate for gestational age group (5.9/2.4%, p<0.05; 5.9/0.7%, p<0.001; 14.5/3.2%, p<0.001; 2/0.2%, p<0.01; 24.3/8.2%, p<0.001; respectively). Rates of ante partum death and post partum death as well as low 1 and 5 minute Apgar scores were significantly higher in the hydramnios/small for gestational age group (9.9/0.3%; 14.5/0.3%; 12.8/2.1%; 11.7/0.6%, p<0.001, respectively). Conclusions. The combination of small for gestational age and hydramnios is a risk factor for peripartum... [ABSTRACT FROM AUTHOR]

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