De Santis Marco, Scavo Maria, Noia Giuseppe, Masini Lucia, Piersigilli Fiammetta, Romagnoli Costantino, Caruso Alessandro
Department of Obstetrics and Gynecology, Catholic University of Sacred Heart, Rome, Italy.
Fetal Diagn Ther. 2003 Nov-Dec;18(6):412-7. doi: 10.1159/000073134.
To evaluate the efficacy of transabdominal amnioinfusion on feto-neonatal and maternal morbidity and feto-neonatal mortality.
We studied 71 patients with preterm premature rupture of membranes (pPROM) at <26 weeks of gestational age. Thirty-four patients were managed expectantly and 37 underwent serial transabdominal amnioinfusion with saline every 7 days in case of persistent oligohydramnios.
Latency period pPROM delivery, week of delivery (26.0 vs. 22.4, p<0.001), neonatal weight (922 vs. 602, p<0.01) and the percentage of intrauterine fetal survival were higher in treated than in control groups (64.8 vs. 32.3%, p<0.01). In amnioinfusion-treated patients, we did not note a higher rate of complications from infection during both pregnancy and puerperium. In the amnioinfusion group, fluid loss within 6 h after infusion is the main variable in predicting pulmonary hypoplasia and neonatal survival.
Our data suggest that amnioinfusion seems to be a low fetal and maternal risk technique that modifies the natural history of pPROM, improving fetal intrauterine stay and survival.
评估经腹羊膜腔灌注术对胎儿-新生儿及母体发病率和胎儿-新生儿死亡率的疗效。
我们研究了71例孕龄小于26周的早产胎膜早破（pPROM）患者。34例患者采取期待治疗，37例在出现持续性羊水过少时每7天接受一次生理盐水连续经腹羊膜腔灌注。
治疗组的pPROM分娩潜伏期、分娩孕周（26.0对22.4，p<0.001）、新生儿体重（922对602，p<0.01）及宫内胎儿存活率均高于对照组（64.8%对32.3%，p<0.01）。在接受羊膜腔灌注治疗的患者中，我们未发现孕期及产褥期感染并发症发生率更高。在羊膜腔灌注组，灌注后6小时内的液体丢失是预测肺发育不全和新生儿存活的主要变量。
我们的数据表明，羊膜腔灌注似乎是一种胎儿和母体风险较低的技术，可改变pPROM的自然病程，改善胎儿宫内状态和存活率。
