title: Treatment of PPROM with anhydramnion in humans: first experience with different amniotic fluid substitutes for continuous amnioinfusion through a subcutaneously implanted port system.
abstract: OBJECTIVE
  This study aims to treat patients with preterm premature rupture of the membranes (PPROM) and anhydramnion using continuous amnioinfusion through a subcutaneously implanted port system.
  
  
  METHODS
  An amniotic fluid replacement port system was implanted in seven patients with PPROM and anhydramnion starting at the 20th week of gestation (range, 14-26 weeks) for long-term amnioinfusion. Saline solutions (2 L/day; Jonosteril(®), Sterofundin(®), isotonic NaCl 0.9% solution, lactated Ringer's solution) and a hypotonic aqueous composition with reduced chloride content similar to the electrolyte concentration of human amniotic fluid were used for the continuous amnioinfusion.
  
  
  RESULTS
  The mean duration of the PPROM delivery interval continued for 49 days (range, 9-69 days), with 3 weeks of amnioinfusion via the port system (range, 4-49). The newborns showed no signs of lung hypoplasia.
  
  
  CONCLUSIONS
  Long-term lavage of the amniotic cavity via a subcutaneously implanted port system in patients with PPROM and anhydramnion may help prolong the pregnancy and avoid fetal lung hypoplasia. A hypotonic aqueous composition with reduced chloride content similar to human amniotic fluid can be safely used for amnioinfusion. Prospective randomized studies are ongoing.
authors.forename: Michael
authors.initials: M
authors.lastname: Tchirikov
authors.forename: Gauri
authors.initials: G
authors.lastname: Bapayeva
authors.forename: Zhaxybay Sh
authors.initials: ZSh
authors.lastname: Zhumadilov
authors.forename: Yasmina
authors.initials: Y
authors.lastname: Dridi
authors.forename: Ralf
authors.initials: R
authors.lastname: Harnisch
authors.forename: Angelika
authors.initials: A
authors.lastname: Herrmann
mesh_terms: D000653:Amniotic Fluid / Q000502:physiology*; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000628:therapy*; D005325:Fetal Organ Maturity; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D055104:Infusions, Subcutaneous; D008168:Lung / Q000196:embryology; D016104:Oligohydramnios / Q000628:therapy*; D011247:Pregnancy; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000517:prevention & control; D062666:Vascular Access Devices