“
“Objective: To investigate the association of epidemiological and pregnancy-related
parameters with the latency period achieved in cases of preterm premature rupture of membranes (PPROM).
Method: A retrospective study was performed enrolling cases admitted in high-risk pregnancy unit (HRPU) with PPROM between 24 + 0 and 36 + 6 gestational week during 2002-2011. Cases with vaginal bleeding at admission, co-existing maternal or fetal pathology, placenta praevia, previous interventions in cervix or uterus, triplets or higher order pregnancies were excluded. Epidemiological parameters and latency period between Ispinesib admission due to PPROM and delivery were recorded. Obstetrical complications, mode of delivery, and neonatal morbidity parameters were also studied. A multivariate regression model was used to correlate latency period with epidemiological and pregnancy-related risk factors.
Results: Overall, there were 319 cases of PPROM admitted, of which 303 (94.9%) met inclusion criteria. Median latency period was 5.2 d. The latency interval exceeded 48 h in 65.0% of cases (197/303). Emergency cesarean was demanded in 20.2% of cases, chorioamnionitis was diagnosed in 7.5% while 76.1% of neonates were admitted in neonatal intensive care unit. Higher
gestational week at admission was associated with shorter latency interval (p < 0.001), twin pregnancy with shorter latency interval (p = 0.02), while latency interval
was significantly lower in cases complicated with chorioamnionitis (p = 0.048).
Conclusion: beta-catenin activation Gestational week at PPROM, twin gestation and chorioamnionitis are factors significantly affecting latency interval.”
“Purpose of review
Clinicians are increasingly using mycophenolate mofetil (MMF) for the treatment of systemic lupus erythematosus (SLE). This review will discuss the key studies that have contributed to our understanding of the efficacy and safety of MMF in the treatment of SLE.
Recent findings
The Aspreva Lupus Management Study (ALMS) firmly established that MMF is equivalent to intravenous pulse cyclophosphamide (IVC) for the induction treatment ML323 of lupus nephritis. In addition, MMF was shown to be superior to azathioprine in decreasing the incidence of treatment failure during maintenance therapy. A posthoc analysis of the induction phase of ALMS suggested that MMF also improved nonrenal manifestations of SLE. In contrast to the ALMS maintenance results, a European trial concluded that MMF and azathioprine were equivalent in the ability to prevent renal flare after induction treatment with low-dose IVC.
Summary
Favorable efficacy and safety results of several clinical trials conducted over the past 10 years have led to the adoption of MMF for the treatment of lupus nephritis and nonrenal lupus.