Amnioinfusion in preterm premature rupture of membranes

Park, Youn Hee; Choi, Soung Kwon; Choi, Yoon Kyong; Lee, Jee Hyun; Moon, Hee Bong; Kim, Sa Jin; Oh, Min Jeong; Shin, Jong Chul; Kim, Soo Pyung

Abstract

OBJECTIVE
Our purpose was to determine the effectiveness of transabdominal amnioinfusion in the pregnant women with preterm premature rupture of the membranes (PPROM).
METHODS
Between March 1997 and June 1999, 54 pregnancies of 26 weeks to 36 weeks of gestation complicated with preterm premature rupture of the membranes were admitted at our institution, 23 patients were excluded from study due to incomplete data, loss follow up or medical diseases was combined. Among included 31 cases were randomly selected either for amnioinfusion (n=16) or expectant management (n=15). After hospitalization, all patients were assessed for fetal heart rate abnormalities, fetal lung maturity and chorioamnionitis. Labor induction was not performed until progressive labor and chorioamnionitis occurred. Amnioinfusion was done through transabdominal catheter and infused group was managed with prophylactic antibiotics and conservative group were treated by hydration and antibiotics.
RESULTS
The median interval from PPROM and delivery was significantly increased in amnioinfused group compared to expectant group (11.19+/-11.52 days vs 3.67+/-5.59 days, p=0.02). There were no differences in 1 minute and 5 minutes Apgar score. However, the duration of incubator treatment and oxygen supplementation were more necessary in expectant group compared to amnioinfused group (p=0.01, respectively). Respiratory distress syndrome was more frequent in expectant group although it did not show statistical significance (20% vs 6%, p<0.25). There was no differences in mode of delivery, birth weight and maternal clinical characteristics between two groups.
CONCLUSION
Our results suggest that active management using transabdominal amnioinfusion in pregnancies complicated with PPROM may give a chance to gain minimal time to accelerate lung maturation and thus improve neonatal outcome without increasing complications.