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Transabdominal amnioinfusion in preterm premature rupture of membranes: a randomised controlled trial
Author(s) -
Tranquilli Andrea Luigi,
Giannubilo Stefano Raffaele,
Bezzeccheri Valeria,
Scagnoli Caterina
Publication year - 2005
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.2005.00544.x
Subject(s) - amnioinfusion , medicine , obstetrics , gestational age , pregnancy , gestation , premature rupture of membranes , randomized controlled trial , population , gynecology , oligohydramnios , surgery , environmental health , biology , genetics
Objective To evaluate the role of transabdominal amnioinfusion in improving the perinatal outcomes of pregnancies complicated by preterm premature rupture of membranes (pPROM). Design A randomised controlled trial. Setting A teaching hospital in Italy, obstetric unit. Population Women with singleton pregnancies complicated by pPROM, between 24 + 0 and 32 + 6 weeks of gestation. Methods Patients were randomised 24 hours after admission to our referral hospital, to expectant management with transabdominal amnioinfusion or expectant management only. Main outcome measures The effects of transabdominal amnioinfusion on pPROM–delivery interval and on perinatal outcomes. Results Of the 65 women with pPROM 34 met the inclusion criteria. Seventeen women were assigned to amnioinfusion (the amnioinfusion group) and the other 17 to expectant management. Compared with the control group (median: 8 days; range: 3–14), the pPROM–delivery period was significantly longer in women who underwent amnioinfusion (median: 21 days; range: 15–29) ( P < 0.05). Women with amnioinfusion were less likely to deliver within seven days since pPROM (RR: 0.18; range: 0.04–0.69 95% CI) or within two weeks (RR: 0.46; range: 0.21–1.02 95% CI). In the amnioinfusion group the neonatal survival was significantly higher at each gestational age ( P < 0.01, Yates's correction for Log Rank Test) with a reduction in pulmonary hypoplasia. Conclusions We demonstrated that compared with standard expectant management the treatment with transabdominal amnioinfusion after pPROM resulted in significant prolongation of pregnancy and better neonatal outcomes.