Continuous amnioinfusion for treatment of mid‐trimester preterm premature rupture of membranes with oligoamnios

摘要

Abstract Aim Given the scarcity of relevant reports, this study aimed to elucidate whether pregnancy can be prolonged by maintaining the amniotic fluid volume with continuous transabdominal amnioinfusion (TA) for patients with mid‐trimester preterm premature rupture of membranes (PPROM) and oligoamnios. Methods We retrospectively examined patients who were managed during hospitalization at our department after developing PPROM between week 22?day 0 and week 25?day 6 of gestation and subsequent oligoamnios (amniotic fluid index [AFI] 5?cm) within 7?days after PPROM onset. Cases between 2006 and 2011 comprised the conventional management group ( n = 14); cases administered continuous TA between 2012 and 2017 comprised the continuous TA group ( n = 14). The primary outcome was the number of days between PPROM and delivery. The secondary outcomes were the proportion of normal amniotic fluid volume (AFI?≥?5?cm) maintained between PPROM and delivery and the perinatal prognosis for the mother and infant. Results The continuous TA group had significantly more days between PPROM and delivery and a significantly higher proportion of days that a normal amniotic fluid volume was maintained during that period, regardless of antimicrobial agents administered. Although no significant differences in the perinatal prognosis of disease were found between groups, there was a decreasing trend of composite perinatal mortality and morbidity, and the incidence rates were reduced by half. Conclusion Continuous TA for PPROM with oligoamnios may allow significant prolongation of the gestation period while maintaining the amniotic fluid volume and may lead to improved perinatal prognosis.