title: Amniopatch procedure after previable iatrogenic rupture of the membranes: a two-center review.
abstract: OBJECTIVE
  This study aimed to analyze success rates and pregnancy outcomes of amniopatch procedures for previable iatrogenic preterm prelabour rupture of the membranes (PPROM) with associated oligohydramnios.
  
  
  METHODS
  Retrospective analysis of amniopatch procedures performed at the University Hospitals Leuven, Belgium, and the Mount Sinai Hospital Toronto, Canada. Cases were analyzed overall and in two sub-groups: PPROM after a needle-based procedure (NP group, n = 13) or after fetoscopic intervention (FI group, n = 11). Complete technical success was defined as cessation of leakage and normalization of amniotic fluid volume, partial success as cessation of leakage, or re-establishment of volume. Further outcomes were pregnancy duration and outcome, fetal/neonatal morbidity and mortality, and maternal morbidity.
  
  
  RESULTS
  Gestational age at amniopatch was comparable in both groups (NP: 20.1, FI: 21.0 weeks). Amniopatch was completely and partially successful in 29% (NP: 31%; FI: 27%) and 29% (NP: 15%; FI: 45%), respectively. Mean gestational age at delivery was 27.5 weeks (NP: 25.5; FI: 29.4 weeks). Overall neonatal survival was 17/31 (55%) (NP: 4/13 (31%), FI: 13/18 (72%); p = .02). Chorioamnionitis occurred in three cases, two associated with maternal sepsis. Severe neonatal morbidity occurred in two survivors.
  
  
  CONCLUSIONS
  Amniopatch for iPPROM was successful in 58%, with an overall live birth rate of 68% and survival to discharge of 55%.
authors.affiliation: Department of Obstetrics and Gynecology, University Hospitals of Leuven, Leuven, Belgium.
authors.forename: Jute
authors.initials: J
authors.lastname: Richter
authors.forename: Amanda
authors.initials: A
authors.lastname: Henry
authors.forename: Greg
authors.initials: G
authors.lastname: Ryan
authors.forename: Philip
authors.initials: P
authors.lastname: DeKoninck
authors.forename: Liesbeth
authors.initials: L
authors.lastname: Lewi
authors.forename: Jan
authors.initials: J
authors.lastname: Deprest
mesh_terms: D000328:Adult; D000649:Amniocentesis / Q000009:adverse effects; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007049:Iatrogenic Disease; D016104:Oligohydramnios / Q000209:etiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult