Transabdominal amnioinfusion for improving fetal outcomes after oligohydramnios secondary to preterm prelabour rupture of membranes before 26 weeks

Teeffelen, S.V.; Pajkrt, Eva; Willekes, Christine; Kuijk, Sander M. J. van; Mol, Ben Willem J.

doi:10.1002/14651858.cd009952.pub2

Cited by 17 publications

(13 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This is especially true when the PPROM occurs before the 26 th week of pregnancy, due to pulmonary underdevelopment, resulting from the scarcity of amniotic fluid with a prolonged latency period. 15 Tavassoli et. al.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of perinatal outcomes in pregnant women with preterm premature rupture of membranes

Souza

Patriota

Guerra

et al. 2016

Rev. Assoc. Med. Bras.

View full text Add to dashboard Cite

Objective: To determine the association between amniotic fluid index (AFI) and perinatal outcomes in preterm premature rupture of membranes (PPROM). Method: A retrospective cohort study was conducted between 2008 and 2012. 86 pregnant women were included, with a diagnosis of PPROM and gestational age from 24 to 35 weeks. Women who presented hypertensive disorders, diabetes, fetuses with birth defects and infection at admission were excluded. To determine the association between AFI and perinatal outcomes, chi-square and Fisher's exact test were used if necessary, as well as risk ratio (RR) and 95% confidence intervals (95CI). Correlation between AFI and perinatal outcomes was determined by using simple linear regression, and AFI progression during pregnancy was analyzed by Z-test. Results: When comparing newborns presenting ultrasound with AFI<5cm and AFI>5cm, there was a higher frequency of perinatal mortality when the AFI was lower than 5 cm. However, when the oligohydramnios was diagnosed as severe (AFI<3cm), there was a higher frequency of Apgar scores less than seven at 1 minute, neonatal sepsis and early neonatal mortality compared to those presenting AFI>3cm. There was a positive correlation between AFI and gestational age at delivery, birth weight and Apgar scores at minutes 1 and 5. There was also a decrease in amniotic fluid volume with increased gestational age. Conclusion:The presence of severe oligohydramnios after PPROM contributed to a higher frequency of perinatal complications and death.

show abstract

Section: Discussionmentioning

confidence: 99%

Evaluation of perinatal outcomes in pregnant women with preterm premature rupture of membranes

Souza

Patriota

Guerra

et al. 2016

Rev. Assoc. Med. Bras.

View full text Add to dashboard Cite

show abstract

“…The initial approach to manage pregnancies complicated by PPROM is based on several parameters assessed upon presentation [ 8 , 9 ]:gestational age, presence of AIS / preterm labor, fetal condition (exposure to antenatal steroids) and availablity of neonatal intensive care. Pregnancies complicated by PPROM ≥ 34 weeks gestational age often receive labor-inducing medication, however, recent data from a randomized controlled trial indicate that this strategy does not substantially improve pregnancy outcomes compared with expectant management [ 10 ].Management of PPROM between 22+0 and 34+0 gestational weeks is still a matter of debate.…”

Section: Introductionmentioning

confidence: 99%

Preterm Prelabor Rupture of Membranes and Outcome of Very-Low-Birth-Weight Infants in the German Neonatal Network

et al. 2015

View full text Add to dashboard Cite

ObjectiveIt was the aim of our study to evaluate the independent effect of preterm prelabor rupture of membranes (PPROM) as a cause of preterm delivery on mortality during primary hospital stay and significant morbidities in very-low-birth-weight (VLBW) infants < 32 weeks of gestation.DesignObservational, epidemiological study design.SettingPopulation-based cohort, German Neonatal Network (GNN).Population6102 VLBW infants were enrolled in GNN from 2009-2012, n=4120 fulfilled criteria for primary analysis (< 32 gestational weeks, no pre-eclampsia, HELLP (highly elevated liver enzymes and low platelets syndrome) or placental abruption as cause of preterm birth).MethodsMultivariable logistic regression analyses included PPROM as potential risk factors for adverse outcomes and well established items such as gestational age in weeks, birth weight, antenatal steroids, center, inborn delivery, multiple birth, gender and being small-for-gestational-age.ResultsPPROM as cause of preterm delivery had no independent effect on the risk of early-onset sepsis, clinical sepsis and blood-culture proven sepsis, while gestational age proved to be the most important contributor to sepsis risk. The diagnosis of PPROM was associated with an increased risk for bronchopulmonary dysplasia (BPD; OR: 1.25, 95% CI: 1.02-1.55, p=0.03) but not with other major outcomes.ConclusionsThe diagnosis of PPROM per se is not associated with adverse outcome in VLBW infants < 32 weeks apart from a moderately increased risk for BPD. Randomized controlled trials with primary neonatal outcomes are needed to determine which subgroup of VLBW infants benefit from expectant or intentional management of PPROM.

show abstract

“…Recently, a Cochrane review assessed the efficacy of this approach with the data from two randomized control trials and concluded that the small number of subjects in those studies precluded a definitive answer in regards to the efficacy of the intervention. 4 A systematic review and meta-analysis suggested a better shortterm prognosis in women with PPROM, who underwent serial amnioinfusion as seen in the reviewed observational studies, but not in the randomized control trials (RCT). The intervention group had significant latency prolongation and improved perinatal and neonatal survival and experienced less pulmonary hypoplasia.…”

Section: Discussionmentioning

confidence: 99%

“…While the data from these trials have been encouraging, lack of safety data and adequate control groups currently prevent this strategy from becoming widely accepted. 4 The case we present is an example of the novel use of serial transabdominal amnioinfusions using oxacillin infused normal saline, in a patient with PROM before the limit of viability.…”

mentioning

confidence: 97%

A Novel Approach to Serial Amnioinfusion in a Case of Premature Rupture of Membranes Near the Limit of Viability

Kohari

Mehlhaff

Merriam

et al. 2018

AJP Rep

View full text Add to dashboard Cite

Prelabor rupture of the membranes (PROM) near the limit of viability is associated with significant risks for both mother and fetus. Preterm labor, intra-amniotic infection, and placental abruption are the immediate risks to the pregnancy; however, the fetus incurs additional risks related to the sequela of persistent oligohydramnios. Transabdominal intra-amniotic infusions have been studied. Results, suggesting that this intervention may prolong the latency period, and potentially, decrease pulmonary hypoplasia in surviving neonates without evidence of increasing risk of intra-amniotic infection. To our knowledge, the use of antibiotic-infused fluid has not been reported in this clinical scenario. Therefore, we present a case of a patient with PROM before the limit of viability who underwent serial transabdominal amnioinfusions with oxacillin-containing normal saline, which resulted in membrane resealing and neonatal survival with no additional maternal morbidity.

show abstract

Transabdominal amnioinfusion for improving fetal outcomes after oligohydramnios secondary to preterm prelabour rupture of membranes before 26 weeks

Abstract: Transabdominal amnioinfusion for improving fetal outcomes after oligohydramnios secondary to preterm prelabour rupture of membranes before 26 weeks.

Cited by 17 publications

References 20 publications

Evaluation of perinatal outcomes in pregnant women with preterm premature rupture of membranes

Evaluation of perinatal outcomes in pregnant women with preterm premature rupture of membranes

Preterm Prelabor Rupture of Membranes and Outcome of Very-Low-Birth-Weight Infants in the German Neonatal Network

A Novel Approach to Serial Amnioinfusion in a Case of Premature Rupture of Membranes Near the Limit of Viability

Contact Info

Product

Resources

About