OBJECTIVE: To evaluate the effect of transabdominal amnioinfusion on prolongation of pregnancy, and maternal and neonatal outcomes in preterm premature rupture of membranes (pPROM). METHODS: We conducted a prospective randomized controlled study of women with pPROM during singleton live pregnancy-between 26 and 33+6weeks-whose amniotic fluid index (AFI) was less than the 5th percentile. The study group underwent transabdominal amnioinfusion at admission and then weekly if their AFI fell below the 5th percentile again. The control group received expectant management. RESULTS: The difference in the mean interval from pPROM to delivery between the groups was not statistically significant. Neonatal and maternal outcomes were significantly improved in the study group compared with the control group (fetal distress [10% vs 37%]; early neonatal sepsis [17% vs 63%]; neonatal mortality [17% vs 63%]; spontaneous delivery [83% vs 53%]; and postpartum sepsis [7% vs 33%]). CONCLUSION:Transabdominal amnioinfusion reduced fetal distress, early neonatal sepsis, and neonatal mortality. In the study group, more participants delivered spontaneously and there were fewer cases of postpartum sepsis, although the pPROM-delivery interval was not increased.
RCT Entities:
OBJECTIVE: To evaluate the effect of transabdominal amnioinfusion on prolongation of pregnancy, and maternal and neonatal outcomes in preterm premature rupture of membranes (pPROM). METHODS: We conducted a prospective randomized controlled study of women with pPROM during singleton live pregnancy-between 26 and 33+6weeks-whose amniotic fluid index (AFI) was less than the 5th percentile. The study group underwent transabdominal amnioinfusion at admission and then weekly if their AFI fell below the 5th percentile again. The control group received expectant management. RESULTS: The difference in the mean interval from pPROM to delivery between the groups was not statistically significant. Neonatal and maternal outcomes were significantly improved in the study group compared with the control group (fetal distress [10% vs 37%]; early neonatal sepsis [17% vs 63%]; neonatal mortality [17% vs 63%]; spontaneous delivery [83% vs 53%]; and postpartum sepsis [7% vs 33%]). CONCLUSION: Transabdominal amnioinfusion reduced fetal distress, early neonatal sepsis, and neonatal mortality. In the study group, more participants delivered spontaneously and there were fewer cases of postpartum sepsis, although the pPROM-delivery interval was not increased.
Authors: Ernesto González-Mesa; Marta Blasco-Alonso; María José Benítez; Cristina Gómez-Muñoz; Lorena Sabonet-Morente; Manuel Gómez-Castellanos; Osmayda Ulloa; Ernesto González-Cazorla; Alberto Puertas-Prieto; Juan Mozas-Moreno; Jesús Jiménez-López; Daniel Lubián-López Journal: Medicina (Kaunas) Date: 2021-05-11 Impact factor: 2.430