Amniopatch Treatment in Spontaneous Previable Preterm Rupture of Membranes with Neonatal Outcomes

Abstract

Objective: To evaluate the efficiency of amniopatch application in previable preterm rupture of membranes (pPPROM) between 17-23 gestational weeks of pregnancy. Methods: 30 pregnants with previable preterm rupture of membranes were given amniopatch as therapy option instead of termination.After one week of antibiotics and bed rest the volunteers were applied amniopatch under sonographic guidance by infusion of 100 mL of 0.9% Isotonic solution alternate infusions of platelets, normal saline and FFP with a total of 100cc of each maximally were given into amniotic cavity. During infusion, in the event of bradycardia, the infusion was stopped. Results: 38 amniopatches were applied to 30 pPPROM patients. 7 aborted, 17 gave an immature birth and 6 gave preterm birth None reached to term. Alive birth rate was %23, All of them were born prematurely with changing durations in Neonatal Intensive Care Unite (NICU). In the 7 alive newborns duration of NICU differed (10 days-91 days) with a mean of 44,5 days. Deepest vertical pocket normalized in only 4 of the 30 patients (13,3%) after one week. There were 2 ablatio plasenta cases, none born alive. Cesarean section rate was 6/30 (%20). Maternal complications were endometritis (5/30, 16%), chorioamnionitis 4/30 (13%) all cured with antbiotic regimens in one week, none had sepsis. Conclusion: Results of amniopatch treatment in pPPROM are not convincing, although you restore the amnion a little bit, the etiopathogenesis and underlying factors still exist and cause premature birth, resulting in neonatal complications.