the feasibility of amniopatch for manegement of mid-trimester rupture of membranes

Mousa, Nabila; Abdelkader, Alshabrawy; Lebda, Ibrahim; Abdeldayem, Hussein; Mourad, Mohammed; Bessar, Ahmed Awad

doi:10.21608/zumj.2019.18331.1594

the feasibility of amniopatch for manegement of mid-trimester rupture of membranes

Document Type : Original Article

Authors

¹ obestetric and gynacology departement faculty of medicine zagazig university -zagazig sharqia

² obestetric and gynacology faculty of medicine zagazig uneversity zagazig sharkia

³ clinical radiology departement faculty of medicine zagazig uneversity zagazig sharkia

⁴ obestetric and gynacology departement faculty of medicine zagazig unversity zagazig sharkia

⁵ clinicalpathology departement faculty of medicine zagazig unversity egypt

⁶ radiology departement, faculty of medicine, zagazig university, zagazig, egypt

10.21608/zumj.2019.18331.1594

Abstract

Background: Mid-trimester preterm premature rupture of membranes (PPROM), defined as rupture of fetal membranes before 28 weeks of gestation, complicates approximately 10-12% of all pregnancies. it is associated with very high perinatal mortality and morbidity. The causes of the mid-trimester PPROM are multifactorial. The management of PPROM requires a balance between the benefits of prolongation of the pregnancy and the risk of intra-amniotic infection and its consequences for the mother and infant. Many optional treatments had been discussed in this issue to improve fetal outcome, these include, expectant management, repeated amnioinfusion, and amniopatch, etc.
Aim: to evaluate the effectiveness of amniopatch in the management of mid-trimester PROM.
Methods: This study was being carried out in the obstetrics and gynecology department, Zagazig university hospitals from January 2016 to December 2018. The study included 36 pregnant women with PPROM from 20 -28 wk. All patients after informed written consent underwent a complete clinical examination and laboratory investigations, and amniopatch was done under complete aseptic conditions.
Results: Out of 36 patients, only 13 cases showed partial success 36,1% (partial success was defined by sealing of membranes and temporary relieve of oligohydramnios). Of partial success cases there were 7 cases 53.8% re ROM again after sealing and 6 cases 46.2% enter in preterm labor despite sealing of membranes, and 23 cases failed 63.9% of which 18 cases missed abortion 78.2%, 3 cases inevitable abortion 13.1%, and 2 cases chorioamnionitis 8.7%.
Conclusion: Amniopatch has only a partial success rate in the management of mid-trimester PPROM.

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