Abstract
The finding of an increased occurrence of prolonged ruptured membranes (ROM) in a group of prematures without RDS led to a prospective study of the effect of prolonged rupture (defined as greater than 16-hour duration) on the subsequent course of premature infants. Seventeen mother-infant pairs were included in the study and steroid determinations (total blood corticosteroids, cortisol, and corticosterone) were performed on paired maternal plasma obtained prior to delivery and infant plasma obtained within the first hour of life. There was a lower incidence of RDS in infants born after greater than 16 hours ROM (0/10), when compared to those who were born after membranes had been ruptured less than 16 hours (4/7). A correlation between steroid levels (both total blood corticosteroids and cortisol) in the infants and duration of ruptured membranes was seen. However, no correlations existed with the duration of labor. It is postulated that the protective influence which prolonged rupture of membranes imparts on the premature fetus is mediated by elevated blood corticosteroids, which result in accelerated lung maturation and a subsequent decreased incidence of respiratory distress syndrome.
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