Transabdominal amnioinfusion treatment of severe oligohydramnios in preterm premature rupture of membranes at less than 26 gestational weeks.
OBJECTIVE
To evaluate the efficacy of transabdominal amnioinfusion on feto-neonatal and maternal morbidity and feto-neonatal mortality.


METHODS
We studied 71 patients with preterm premature rupture of membranes (pPROM) at <26 weeks of gestational age. Thirty-four patients were managed expectantly and 37 underwent serial transabdominal amnioinfusion with saline every 7 days in case of persistent oligohydramnios.


RESULTS
Latency period pPROM delivery, week of delivery (26.0 vs. 22.4, p<0.001), neonatal weight (922 vs. 602, p<0.01) and the percentage of intrauterine fetal survival were higher in treated than in control groups (64.8 vs. 32.3%, p<0.01). In amnioinfusion-treated patients, we did not note a higher rate of complications from infection during both pregnancy and puerperium. In the amnioinfusion group, fluid loss within 6 h after infusion is the main variable in predicting pulmonary hypoplasia and neonatal survival.


CONCLUSIONS
Our data suggest that amnioinfusion seems to be a low fetal and maternal risk technique that modifies the natural history of pPROM, improving fetal intrauterine stay and survival.
De Santis
Marco
M
Department of Obstetrics and Gynecology, Catholic University of Sacred Heart, Rome, Italy. marcodesantis@rm.unicatt.it
Scavo
Maria
M
Noia
Giuseppe
G
Masini
Lucia
L
Piersigilli
Fiammetta
F
Romagnoli
Costantino
C
Caruso
Alessandro
A
D000328:Adult; D000650:Amnion / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000382:microbiology; D016009:Chi-Square Distribution; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000382:microbiology; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007263:Infusions, Parenteral / Q000379:methods; D008297:Male; D016104:Oligohydramnios / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000382:microbiology; D011247:Pregnancy; D011446:Prospective Studies; D012965:Sodium Chloride / Q000008:administration & dosage / Q000627:therapeutic use; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D014463:Ultrasonography
D012965:Sodium Chloride