Is There Significant Improvement in Neonatal Outcome after Treating pPROM Mothers with Amnio-Infusion?

Abstract

The aim of this study was to determine the effects of amnio-infusion treatment on fetal and neonatal mortality and neonatal pulmonary development in women with singleton pregnancies and premature rupture of the membranes occurring at a gestational age of <26 weeks and who had severe oligohydramnios. The treated group of 45 consenting women received serial amnio-infusion and was compared with the control group of 44 women who underwent waiting treatment. Our study confirmed a higher number of live births in the treated group, especially in cases with a gestational age at rupture (GAR) of <20 weeks. Furthermore, even if GAR is an important factor for predicting pulmonary hypoplasia, amnio-infusion treatment reduces the probability of pulmonary hypoplasia. In fact, over 20 weeks, amnio-infusion treatment significantly reduces the risk of pulmonary hypoplasia even if normal lung development cannot be guaranteed.

Amnioinfusion in preterm premature rupture of membranes (AMIPROM): a randomised controlled trial of amnioinfusion versus expectant management in very early preterm premature rupture of membranes – a pilot study

“…Locatelli et al 8 found that pregnancies with a median residual amniotic fluid pocket persistently less than 2 cm were at highest risk of poor perinatal and long-term neurological outcome while pregnancies with a pocket greater than 2 cm had significantly better perinatal outcome (73-92% survival) and lower pulmonary hypoplasia rates. 8,9 What management options are available?…”

“…[3][4][5][6][7][8][9][10][11] The major risk of expectant is maternal infection leading to sepsis. High rates of postpartum morbidity 10 and chorioamnionitis 11 have been reported: 32% and 28%, respectively.…”

“…The median number of antenatal visits prior to delivery was 5 (range 0-15) in the AI arm and 4.5 (range [1][2][3][4][5][6][7][8][9][10][11][12][13][14] in the Exp arm ( Table 5). The median number of AI performed was 3 (range 0-12; Table 6).…”

Severe antenatally diagnosed renal disorders: background, prognosis and practical approach

“…It is debatable whether antepartum amnioinfusion can prevent or ameliorate the consequences or even the degree of pulmonary hypoplasia in neonates and fetuses. Experimental evidence is in favour of its use, which also seems to be supported by recent studies, at least in some cases after the premature rupture of membranes [37][38][39]. Systematic studies on fetuses with ROH have not been performed, yet a recent case report indicates a potential benefit even in a fetus with bilateral renal agenesis [40].…”

Successful Outcome following Antepartum Amnioinfusion in Pregnancy Complicated with Severe Oligohydramnios with APLA Syndrome

“…In pregnancies complicated by oligohydramnios at 26 weeks, the rate of pulmonary hypoplasia is down to 46% in women receiving amnioinfusion, compared with 86% in nonamnioinfused women. 7 Cerebral hemorrhage of more than second-degree severity and/or periventricular leukomalacia appear to be absent in cases of oligohydramnios treated by amnioinfusion between 24 and 32 weeks, but are present in 26% of untreated cases. 8 Several authors also report a longer latency period between PROM and term in women receiving amnioinfusion compared with nonamnioinfused women with average latency period varying between a minimum of 15 days up to a maximum of 89 days in those cases in which amnioinfusion allows the amniotic fluid level to be stabilized for over 48 hours vs 7 to 22 days in nonamnioinfused cases.…”