J Perinat Med. 2013 Nov;41(6):657-63. doi: 10.1515/jpm-2012-0296.
This study aims to treat patients with preterm premature rupture of the membranes (PPROM) and anhydramnion using continuous amnioinfusion through a subcutaneously implanted port system.
An amniotic fluid replacement port system was implanted in seven patients with PPROM and anhydramnion starting at the 20th week of gestation (range, 14-26 weeks) for long-term amnioinfusion. Saline solutions (2 L/day; Jonosteril(®), Sterofundin(®), isotonic NaCl 0.9% solution, lactated Ringer's solution) and a hypotonic aqueous composition with reduced chloride content similar to the electrolyte concentration of human amniotic fluid were used for the continuous amnioinfusion.
The mean duration of the PPROM delivery interval continued for 49 days (range, 9-69 days), with 3 weeks of amnioinfusion via the port system (range, 4-49). The newborns showed no signs of lung hypoplasia.
Long-term lavage of the amniotic cavity via a subcutaneously implanted port system in patients with PPROM and anhydramnion may help prolong the pregnancy and avoid fetal lung hypoplasia. A hypotonic aqueous composition with reduced chloride content similar to human amniotic fluid can be safely used for amnioinfusion. Prospective randomized studies are ongoing.
本研究旨在通过皮下植入式端口系统对胎膜早破伴羊水过少的患者进行持续性羊膜腔灌注。
从妊娠 20 周（14-26 周）开始，对 7 例胎膜早破伴羊水过少的患者植入羊膜腔灌注端口系统，进行长期羊膜腔灌注。使用生理盐水（2 L/天；Jonosteril®、Sterofundin®、等渗 NaCl 0.9%溶液、乳酸林格氏液）和一种低张水性组合物，其氯离子含量较低，与人类羊水的电解质浓度相似，用于持续性羊膜腔灌注。
PPROM 分娩间隔的平均持续时间为 49 天（9-69 天），通过端口系统进行 3 周的羊膜腔灌注（4-49 天）。新生儿均无肺发育不全的迹象。
在胎膜早破伴羊水过少的患者中，通过皮下植入式端口系统对羊膜腔进行长期冲洗可能有助于延长妊娠时间并避免胎儿肺发育不全。一种氯离子含量较低、与人类羊水相似的低张水性组合物可安全用于羊膜腔灌注。目前正在进行前瞻性随机研究。
