Transabdominal Amnioinfusion Treatment of Severe Oligohydramnios in Preterm Premature Rupture of Membranes at Less Than 26 Gestational Weeks

Santis, Marco De; Scavo, Maria Principia; Noia, G.; Masini, Lucia; Piersigilli, Fiammetta; Romagnoli, C; Caruso, Alessandro

doi:10.1097/00006254-200405000-00004

Cited by 17 publications

(22 citation statements)

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“…De Santis et al [5] demonstrated that repetitive transabdominal amnioinfusions for the treatment of PPROM displayed only a minimal benefit in the case of fluid loss within 6 h. In our study, the inclusion criteria for continuous amnioinfusion via a port system were classic PPROM syndrome and anhydramnion in the early gestation with a massive loss of amniotic fluid. Within 1 h, the patients lost the infused fluid.…”

Section: Discussionmentioning

confidence: 64%

“…Tranquilli et al [23] demonstrated in a prospective randomized study that serial transabdominal amnioinfusion significantly prolonged the PPROM-to-delivery period and improved neonatal outcome. Unfortunately, the use of repetitive transabdominal amnioinfusions for the treatment of PPROM showed only a minimal benefit as measured by fluid loss within 6 h [5].…”

Section: Introductionmentioning

confidence: 99%

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Treatment of PPROM with anhydramnion in humans: first experience with different amniotic fluid substitutes for continuous amnioinfusion through a subcutaneously implanted port system

Tchirikov

Bapayeva

Zhumadilov

et al. 2013

Journal of Perinatal Medicine

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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 20 th 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. Conclusion: 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.

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Section: Discussionmentioning

confidence: 64%

Section: Introductionmentioning

confidence: 99%

Treatment of PPROM with anhydramnion in humans: first experience with different amniotic fluid substitutes for continuous amnioinfusion through a subcutaneously implanted port system

Tchirikov

Bapayeva

Zhumadilov

et al. 2013

Journal of Perinatal Medicine

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“…12 Locatelli A, Vergani P, et al and Marco De Santis et al also reported a significant increase in birth weight in the amnioinfused group. 15,19 In present study, the incidence of newborn admissions to neonatal ICU was 20.4%. Anshuja Singla et al reported a significant improvement in the neonatal survival in study group.…”

Section: Discussionmentioning

confidence: 48%

Therapeutic amnioinfusion in oligohydramnios during pregnancy (excluding labor)

Qazi

Saqib

Ahmad

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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Background: Oligohydramnios is a serious complication of pregnancy that is associated with a poor perinatal outcome and complicates 1-5% of pregnancies. The purpose of this study was to evaluate the role of antepartum transabdominal amnioinfusion on amniotic fluid volume/latency period in pregnancies with oligohydramnios.Methods: This study was conducted in the Department of Obstetrics and Gynaecology at Sher-i-Kashmir Institute of Medical Sciences Soura Srinagar. In this study, a total of 54 pregnant women with ultrasonographically diagnosed oligohydramnios i.e. AFI < 5 cm and gestational age of >24 weeks were taken for therapeutic amnioinfusion and its effects on amniotic fluid volume were studied. Statistical Software SPSS (Version 20.0) and Microsoft excel were used to carry out the statistical analysis of data. P-value less than 0.05 was considered statistically significant.Results: Mean age of patients in our study was 27.5±3.19 years and gestational age group of 28-34 weeks. The mean AFI pre and post amnioinfusion was found to be 3.3 cm and 8.8 cm respectively. The difference was found to be statistically significant with a p value of <0.001. There was increase in the latency period in the studied patients with a mean latency period of 42.8±14.94 days. Mean number of transabdominal amnioinfusions in our study was 1.48±0.64. In our study, majority of patients i.e. 33 (61.1%) delivered at 38-40 weeks with a mean age at delivery 37.4±1.92 weeks. In our study, maximum number of patients i.e. 32 (59.3%) were delivered by full term normal delivery and only 15 (27.8%) required caesarean section. 78% of newborns weighed >2.5kg. The mean weight of newborn was 2.9±0.59 kgs. The incidence of newborn admissions to NICU was 20.4%. Number of neonatal deaths in our study was 5.6%. There was reduction of neonatal admission to NICU and neonatal deaths after transabdominal amnioinfusion.Conclusions: Antepartum transabdominal amnioinfusion is a useful procedure to reduce complications resulting from decreased intra-amniotic volume. It significantly raises the amniotic fluid especially useful in preterm pregnancies, where the procedure allows for a better perinatal outcome by significantly prolonging the duration of pregnancy, increasing birth weight, preventing fetal distress and thereby reducing operative intervention. Optimizing the selection of patients who are good candidates for the procedure is a prerequisite.

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“…[1][2][3] Amnioinfusion is the only approach that has been evaluated by independent investigators in nonrandomized series and it has been shown to lead to higher perinatal survival rates and lower incidence of pulmonary hypoplasia compared with expectant management. [1][2][3][4][5][6] A recent randomized study 7 confirmed a significant prolongation of pregnancy in cases managed with amnioinfusion.…”

Section: Introductionmentioning

confidence: 95%

Amnioinfusion in preterm PROM: effects on amnion and cord histology

et al. 2007

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Objective: To investigate the effects of transabdominal amnioinfusion (TA) on the histology of amnion (A) and umbilical cord (UC).Study Design: From a cohort of 56 singleton pregnancies with premature rupture of membranes (PROM) at p24.6 weeks, we excluded those who did not develop severe oligohydramnios (n ¼ 12). Of the 44 patients, 29 consented to TA and 15 declined the procedure. TA was performed with normal saline solution.Result: Women who consented to TA underwent a median of three procedures had a gestational age at PROM of 18.7 weeks and at delivery of 26.1 weeks, with a latency of 50 days. Compared with subjects who declined the procedure, TA had a beneficial effect on clinical variables, mediated primarily by a longer latency. TA was not associated with identifiable effects on the histologic features of A or UC. Conclusion:A and UC histology is not significantly affected by exposure to saline solution even for prolonged periods of time.

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Transabdominal Amnioinfusion Treatment of Severe Oligohydramnios in Preterm Premature Rupture of Membranes at Less Than 26 Gestational Weeks

Cited by 17 publications

References 0 publications

Treatment of PPROM with anhydramnion in humans: first experience with different amniotic fluid substitutes for continuous amnioinfusion through a subcutaneously implanted port system

Treatment of PPROM with anhydramnion in humans: first experience with different amniotic fluid substitutes for continuous amnioinfusion through a subcutaneously implanted port system

Therapeutic amnioinfusion in oligohydramnios during pregnancy (excluding labor)

Amnioinfusion in preterm PROM: effects on amnion and cord histology

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