Premature rupture of membranes after serial amnioinfusions in fetuses with early anhydramnios due to severe renal disease/lower urinary obstruction.

IF 1.6 3区医学 Q3 OBSTETRICS & GYNECOLOGY

Fetal Diagnosis and Therapy Pub Date : 2026-04-10 DOI:10.1159/000551948

Edgar Hernandez-Andrade, Kevin Magee, Donatella Gerulewicz Vannini, Jimmy Espinoza, Percy Pacora Pacotella, Dejian Lai, Sami Backley, Felicia Venable Lemoine, Ramesha Papanna, Anthony Johnson

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引用次数: 0

Abstract

Aim: This study estimates the frequency of preterm premature rupture of membranes (PPROM) in fetuses with early anhydramnios due to severe renal or urinary disease treated with serial amnioinfusions (AIs).

Methods: Fetuses diagnosed with early anhydramnios (<25 weeks gestation) secondary to severe renal disease or urinary tract obstruction underwent serial AIs at two centers, to reduce uterine compression and prevent pulmonary hypoplasia. Fetuses with structural or chromosomal anomalies were excluded. AIs were performed to maintain an amniotic fluid index (AFI) of 15-20 cm. Patients were monitored biweekly, and AIs were repeated whenever AFI decreased to 5-8 cm. Signs of fetal distress, membrane detachment, and clinical chorioamnionitis were closely monitored. PPROM was defined as spontaneous membrane rupture before 35 weeks gestation, or delivery. The frequency of PPROM was analyzed in relation to gestational age at diagnosis, and to the number of AIs performed. Associations between the number of AIs and PPROM were evaluated with logistic regression analysis.

Results: A total of 340 AIs were performed in 32 fetuses between 19 and 35 weeks gestation with a median (range) of 13 (2-22) AIs per patient. PPROM occurred in 12 patients (37.5%), with seven cases (21.8%) occurring before 32 weeks. PPROM occurred in 30.8% (4/13) of cases with 2-9 AIs and in 42.1% (8/19) of cases with 10-22 AIs (OR 1.6 [95% CI 0.36-7.25; p=0.51]). Twenty (62.5%) cases reached 35 weeks or delivery without PPROM. Notably, 28/32 patients (87.5%) completed 9 AIs without presenting PPROM. No PPROM occurred before 26 weeks.

Conclusion: The overall risk of PPROM <35 weeks following serial AIs for early anhydramnios due to severe renal or urinary tract disease was 37.5%. Despite no significant differences in PPROM related to the number of AIs, there is an increment in PPROM frequency after nine AIs.

查看原文本刊更多论文

严重肾脏疾病/下尿路梗阻导致早期羊水无的胎儿连续羊水输注后羊膜过早破裂

目的：本研究评估连续羊膜输注（AIs）治疗严重肾脏或泌尿系统疾病引起的早期羊水胎儿的早产早破膜（PPROM）的频率。方法：诊断为早期羊水无的胎儿(结果：32例妊娠19 ~ 35周的胎儿共行340例人工智能，平均（范围）为13例（2 ~ 22例）。PPROM发生12例（37.5%），32周前发生7例（21.8%）。2-9个AIs患者中有30.8%（4/13）发生PPROM， 10-22个AIs患者中有42.1%（8/19）发生PPROM （OR 1.6 [95% CI 0.36-7.25; p=0.51]）。20例（62.5%）达到35周或分娩时未出现PPROM。值得注意的是，32例患者中有28例（87.5%）完成了9次ai，未出现PPROM。26周前未发生PPROM。结论：PPROM的总体风险

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来源期刊

Fetal Diagnosis and Therapy 医学-妇产科学

CiteScore

4.70

自引率

9.10%

发文量

审稿时长

6-12 weeks

期刊介绍： The first journal to focus on the fetus as a patient, ''Fetal Diagnosis and Therapy'' provides a wide range of biomedical specialists with a single source of reports encompassing the common discipline of fetal medicine.